Active NPI
Gerald Stephen Murphy Jr., M.D.
- Infectious Disease Physician
- Fort Wayne, IN
National Provider Identifier
1457519225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 036-074408
- Practice address
- 2200 Randallia Dr
Fort Wayne, IN 46805-4638 - Phone
- (260) 373-6315
- Fax
- (260) 373-6348
- NPI assigned
- May 29, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 036-074408 | IL | |
| Internal Medicine Physician | 207R00000X | 036-074408 | IL | |
| Infectious Disease Physician | 207RI0200X | 036-074408 | IL | Primary |
| Public Health & General Preventive Medicine Physician | 2083P0901X | 036-074408 | IL | |
| Medical Toxicology (Preventive Medicine) Physician | 2083T0002X | 036-074408 | IL | |
| Occupational Medicine Physician | 2083X0100X | 036-074408 | IL | |
| General Practice Physician | 208D00000X | 036-074408 | IL |
Addresses
Primary practice location
2200 Randallia Dr
Fort Wayne, IN 46805-4638
Mailing address
1234 E. Dupont Rd.
Suite 3
Fort Wayne, IN 46825-1545
Phone (260) 373-9728
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000602075 | Other | IN | ANTHEM |
| 200929700 | Medicaid | IN | |
| P00732018 | Other | IN | RAILROAD MEDICARE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-074408 | IL | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255478400000",
"number": "1457519225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1234 E. DUPONT RD.",
"address_2": "SUITE 3",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468251545",
"telephone_number": "260-373-9728",
"fax_number": "260-458-5664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 RANDALLIA DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468054638",
"telephone_number": "260-373-6315",
"fax_number": "260-373-6348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MURPHY",
"first_name": "GERALD",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-29",
"last_updated": "2009-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036-074408",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036-074408",
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "IL",
"license": "036-074408",
"primary": true
},
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "IL",
"license": "036-074408",
"primary": false
},
{
"code": "2083T0002X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Medical Toxicology",
"state": "IL",
"license": "036-074408",
"primary": false
},
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "IL",
"license": "036-074408",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "IL",
"license": "036-074408",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000602075",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200929700",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00732018",
"state": "IN"
}
],
"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 Oct 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.