Center for Colon and Rectal Care LLC

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

Legal business name

CENTER FOR COLON AND RECTAL CARE LLC

Practice address

12012 Wood Glen Dr
Fort Wayne, IN 46814-4515

Phone

(260) 672-1719

NPI assigned

Sep 10, 2009

Organization subpart

No

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

Authorized official

Name

Nadine L. Floyd, MD

Title

Chief Operating Officer

Phone

(260) 672-1719

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1252540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1568795409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12012 WOOD GLEN DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468144515",
            "telephone_number": "260-672-1719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12012 WOOD GLEN DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468144515",
            "telephone_number": "260-672-1719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR COLON AND RECTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-10",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "FLOYD",
        "authorized_official_first_name": "NADINE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "260-672-1719",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Colon & Rectal Surgery Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Colon & Rectal Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.

Verify at the official NPI Registry.