Active NPI
Diane Nicole Gutgsell, PHARMD
- Pharmacotherapy Pharmacist
- Fort Wayne, IN
National Provider Identifier
1396463956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 26030090A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26030090A | Other | IN | PHARMACIST LICENSE |
| 5302414434 | Other | MI | PHARMACIST 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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302414434 | MI | MD | Pharmacist |
| 26030090A | IN | MD | Pharmacotherapy 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.