Individual provider Active NPI

David K Powell, M.D.

  • Diagnostic Radiology Physician
  • Fort Wayne, IN
National Provider Identifier
1336193424
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
02037906 Issued in IN
Practice address
3707 New Vision Dr
Fort Wayne, IN 46845-1702
Phone
(260) 471-9466
NPI assigned
May 22, 2006
Last updated
Jul 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 02037906 IN Primary

Addresses

Primary practice location

3707 New Vision Dr
Fort Wayne, IN 46845-1702

Mailing address

3707 New Vision Dr
Fort Wayne, IN 46845-1702
Phone (260) 471-9466

Other practice location 1

2200 Randallia Dr
Fort Wayne, IN 46805-4638
Phone (260) 373-4731

Other practice location 2

2200 Randallia Dr
Fort Wayne, IN 46805-4638
Phone (260) 373-4731

Other identifiers 5

IdentifierTypeStateIssuer
4074942100MedicaidMI
1712OtherINPHP
2100612MedicaidOH
000000092607OtherINANTHEM
100323460MedicaidIN

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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02037906INMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Radiology P C Diagnostic Radiology Past Accepting new patients
Parkview Hospital Inc. Past Accepting new patients
MRI Center - Fort Wayne Radiology Inc Diagnostic Radiology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dkpowell@direct.iuhealth.org
  • Direct secure messaging: dpowell@yourcarecommunity.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1336193424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451702",
            "telephone_number": "260-471-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451702",
            "telephone_number": "260-471-9466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Randallia Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468054638",
            "country_code": "US",
            "telephone_number": "260-373-4731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Randallia Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468054638",
            "country_code": "US",
            "telephone_number": "260-373-4731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "DAVID",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "02037906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4074942100",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "1712",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2100612",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000092607",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100323460",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.