NPIMap

Individual provider Active NPI

John S. Pidgeon, MD

  • Neurology Physician
  • Fort Wayne, IN
National Provider Identifier
1306050257
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
01080867A Issued in IN
Practice address
2231 Carew St
Fort Wayne, IN 46805-4713
Phone
(260) 425-6780
NPI assigned
May 10, 2007
Last updated
Sep 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 49759 KY
Neurology Physician 2084N0400X 01080867A IN Primary

Addresses

Primary practice location

2231 Carew St
Fort Wayne, IN 46805-4713

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330

Other practice location 1

1301 Pleasant Valley Rd
Suite 500C
Owensboro, KY 42303-9774
Phone (270) 417-7830

Other identifiers 3

IdentifierTypeStateIssuer
300001793MedicaidIN
7100441610MedicaidKY
G8894681MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180817002086 IN Practitioner - Neurology 2860545712 Reassigns benefits to 1 organization
I20201221001314 IL Practitioner - Neurology 2860545712 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wabash General Hospital DistrictGroup PAC ID 8022908185, shared by 10 NPIs, 77 clinicians
Union Hospital IncGroup PAC ID 8426943614, 90 clinicians

Practice addresses (Care Compare)

1418 College Dr
Mount Carmel, IL 62863-2638
Phone (618) 262-8621

1606 N 7TH St
Union Hospital Inc Medical Group
Terre Haute, IN 47804-2706
Phone (812) 238-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8425NEMDMental Health Counselor
49759KYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital, Inc. CurrentSince Sep 18, 2022 Accepting new patients
Wabash General Hospital District Current Accepting new patients
Wabash General Hospital District Current Accepting new patients
St Lukes Clinic-Treasure Valley LLC Neurology CurrentSince Dec 1, 2020 Accepting new patients
Union Hospital, Inc. CurrentSince Sep 18, 2022 Accepting new patients
Wabash General Hospital District CurrentSince Nov 13, 2020 Accepting new patients
Wabash General Hospital District CurrentSince Nov 13, 2020 Accepting new patients
North Platte Nebraska Hospital Corporation Neurology PastSince Jul 6, 2016 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

520 S Eagle Rd
Meridian, ID 83642
Phone (208) 706-5000

1418 College Dr
Mount Carmel, IL 62863
Phone (618) 262-8621

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Interoperability endpoints

  • Direct secure messaging: jpidgeon193923@direct.slhs.org

Organizations & group practices 8

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

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1306050257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 CAREW ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054713",
            "telephone_number": "260-425-6780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Pleasant Valley Rd",
            "address_2": "Suite 500C",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423039774",
            "country_code": "US",
            "telephone_number": "270-417-7830",
            "fax_number": "270-417-7839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIDGEON",
        "first_name": "JOHN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "49759",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01080867A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300001793",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100441610",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G8894681",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.