Active NPI
Allied Physicians Inc., D/B/a Fort Wayne Neurosurgery
- Neurological Surgery Physician
- Fort Wayne, IN
National Provider Identifier
1255322103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- Legal business name
- ALLIED PHYSICIANS INC., D/B/A FORT WAYNE NEUROSURGERY
- Practice address
- 2622 Lake Ave
Fort Wayne, IN 46805-5410 - Phone
- (260) 460-3100
- NPI assigned
- Oct 31, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stephen R Smith
- Title
- Ceo/Treasurer
- Phone
- (260) 436-2416
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | Primary |
Addresses
Primary practice location
2622 Lake Ave
Fort Wayne, IN 46805-5410
Mailing address
2622 Lake Ave
Fort Wayne, IN 46805-5410
Phone (260) 460-3100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040327000031 | IN | Part B Supplier - Clinic/Group Practice | 5193625846 |
Receives reassigned benefits from 7 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Fort Wayne, IN |
Other NPIs on the same Medicare enrollment 5
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Magnetic Resonance Imaging (MRI) Clinic/Center
- Fort Wayne, IN
- NPI 1033100995
O20040327000031
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130716800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1255322103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2622 LAKE AVE",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468055410",
"telephone_number": "260-460-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2622 LAKE AVE",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468055410",
"telephone_number": "260-460-3100"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALLIED PHYSICIANS INC., D/B/A FORT WAYNE NEUROSURGERY",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-31",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SMITH",
"authorized_official_first_name": "STEPHEN",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "CEO/TREASURER",
"authorized_official_telephone_number": "260-436-2416"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Neurological Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
- Allied Physicians Inc
- Allied Physicians Inc
- Allied Physicians Inc
- Allied Physicians Inc., D/B/a Ear, Nose & Throat Specialists
- Allied Physicians Inc., D/B/a Fort Wayne Neurosurgery
- Allied Physicians Inc., D/B/a Indiana Ohio Heart
- Allied Physicians Inc., D/B/a Tri-State Physical Medicine
- Allied Physicians Inc., D/B/a Tri-State Physical Medicine
- Allied Physicians, Inc.
- Allied Physicians, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.