Fred L. Rasp, MD
Individual provider Active NPI Internal Medicine Physician · Fort Wayne, IN
NPI 1346217072 · NPPES record last updated Jan 19, 2017
Key facts
- NPI
- 1346217072
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 01024370A (IN)
- Practice address
- 7952 W Jeffferson Blvd
Fort Wayne, IN 46804-4140 - Phone
- (260) 435-2836
- Fax
- (260) 435-7585
- NPI assigned
- Mar 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Medical Group of Fort Wayne, P.C. | Internal Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01024370A | IN | Yes |
Addresses
Primary practice location
7952 W Jeffferson Blvd
Fort Wayne, IN 46804-4140
Mailing address
6920 Pointe Inverness Way Ste 200
Medpartners, Attn: Megan Fortney
Fort Wayne, IN 46804-7934
Phone (260) 479-3515
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000087415 | Other | IN | ANTHEM |
| P00783794 | Other | IN | RAILROAD MEDICARE |
| 0624739 | Medicaid | OH | |
| 100355530 | Medicaid | IN |
Other providers in Fort Wayne, IN
- Rose A Rarey
- Shamari Rashawans
- Kari M Rasmussen
- Ronalee Marie Rasmussen
- Faisal Rasooli
- Jenna Raspiller
- Vikki Ratcliff
- Nancy Sansom Rathburn
- Carl T Ratliff
- Nancy C Ratliff
All providers in Fort Wayne, IN · Internal Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.