Organization Active NPI

Fort Wayne Medical Oncology and Hematology, Inc.

  • Hematology & Oncology Physician
  • Angola, IN
National Provider Identifier
1528044005
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
FORT WAYNE MEDICAL ONCOLOGY AND HEMATOLOGY, INC.
Practice address
516 E Maumee St
Angola, IN 46703-2017
Phone
(260) 668-4040
Fax
(260) 668-3897
NPI assigned
Dec 16, 2005
Organization subpart
Yes
Parent organization
FORT WAYNE MEDICAL ONCOLOGY AND HEMATOLOGYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Authorized official

Name
Anne Krahn
Title
Practice Manager
Phone
(260) 969-7868

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

516 E Maumee St
Angola, IN 46703-2017

Mailing address

PO Box 15099
Fort Wayne, IN 46885-5099
Phone (260) 484-8830

Other identifiers 1

IdentifierTypeStateIssuer
CA4536OtherINMEDICARE RR

National Provider Directory

National Provider Directory
Part of
Ft Wayne Medical Oncology

Locations

11143 Parkview Plaza Dr
#1
Fort Wayne, IN 46845

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1528044005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15099",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468855099",
            "telephone_number": "260-484-8830",
            "fax_number": "260-483-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032017",
            "telephone_number": "260-668-4040",
            "fax_number": "260-668-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE MEDICAL ONCOLOGY AND HEMATOLOGY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FORT WAYNE MEDICAL ONCOLOGY AND HEMATOLOGY",
        "enumeration_date": "2005-12-16",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "KRAHN",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "260-969-7868"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "CA4536",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.