Individual provider Active NPI

John Rex Parent, M.D.

  • Ophthalmology Physician
  • Fort Wayne, IN
National Provider Identifier
1275545873
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
01023963 Issued in IN
Practice address
321 E Wayne St
Fort Wayne, IN 46802-2713
Phone
(260) 424-5656
Fax
(260) 424-4511
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 01023963 IN Primary

Addresses

Primary practice location

321 E Wayne St
Fort Wayne, IN 46802-2713

Mailing address

4625 N Washington Rd
Fort Wayne, IN 46804-1831

Other identifiers 4

IdentifierTypeStateIssuer
1669OtherINPHYSICIAN'S HEALTH PLAN
000000083765OtherINANTHEM
0420226MedicaidOH
200014170MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Indiana University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

321 E Wayne St
Fort Wayne, IN 46802-2713

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01023963INMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Eye Surgical Center of Fort Wayne, LLC PastSince Jan 1, 2010 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294272000000",
    "number": "1275545873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 N WASHINGTON RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 E WAYNE ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468022713",
            "telephone_number": "260-424-5656",
            "fax_number": "260-424-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARENT",
        "first_name": "JOHN",
        "middle_name": "REX",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2011-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01023963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN'S HEALTH PLAN",
            "identifier": "1669",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000083765",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0420226",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200014170",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.