Jeffrey P Squires, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

1028175 Issued in IN

Practice address

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Phone

(260) 435-7154

Fax

(260) 435-7633

NPI assigned

Jul 6, 2006

Last updated

Jan 28, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Fort Wayne Gi Pathology Services, PC, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Fort Wayne, IN
  • NPI 1821133901
  NPD (past)
• Indiana Pathology Consultants, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Fort Wayne, IN
  • NPI 1467597062
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296172800000",
    "number": "1326070152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240B MALLARD COVE LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042883",
            "telephone_number": "260-432-5867",
            "fax_number": "260-436-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-435-7154",
            "fax_number": "260-435-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIRES",
        "first_name": "JEFFREY",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2011-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "1028175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "220011660",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100348010",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cindy G. Spryn, NP
• Hayden Michael Spryn, PA-C
• Amy Spurling, PA
• Kaylee Spurlock
• Deborah Marie Spurr, N.P.
• Sunay Srinivas, MD
• Srisai P C (Anuradha Kollipara, MD)
• SRT Prosthetics & Orthotics LLC (ForMotion Clinic)
• St Joseph Health System LLC (Lutheran Downtown Hospital)
• St Joseph Health System LLC (St. Joseph Hospital Gero)

• Anatomic Pathology & Clinical Pathology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Anatomic Pathology & Clinical Pathology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.