Individual provider Active NPI

Diane Nicole Gutgsell, PHARMD

  • Pharmacotherapy Pharmacist
  • Fort Wayne, IN
National Provider Identifier
1396463956
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
26030090A Issued in IN
Practice address
1717 S Calhoun St
Fort Wayne, IN 46802-5257
Phone
(260) 458-2641
NPI assigned
Aug 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302414434 MI
Pharmacotherapy Pharmacist 1835P1200X 26030090A IN Primary

Addresses

Primary practice location

1717 S Calhoun St
Fort Wayne, IN 46802-5257

Mailing address

12853 Slash Pass
Fort Wayne, IN 46818-0062
Phone (812) 881-1741

Other practice location 1

3350 E Paulding Rd
Fort Wayne, IN 46816-4513
Phone (260) 458-2641

Other identifiers 2

IdentifierTypeStateIssuer
26030090AOtherINPHARMACIST LICENSE
5302414434OtherMIPHARMACIST LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
5302414434MIMDPharmacist
26030090AINMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1396463956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12853 SLASH PASS",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468180062",
            "telephone_number": "812-881-1741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S CALHOUN ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468025257",
            "telephone_number": "260-458-2641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3350 E Paulding Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468164513",
            "country_code": "US",
            "telephone_number": "260-458-2641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTGSELL",
        "first_name": "DIANE",
        "middle_name": "NICOLE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-19",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302414434",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "IN",
            "license": "26030090A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "26030090A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE NUMBER",
            "identifier": "5302414434",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; 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.