ENT Realty Corp

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ENT REALTY CORP

Doing business as

The Surgery Center

Practice address

7900 W Jefferson Blvd
Suite 102
Fort Wayne, IN 46804-4128

Phone

(260) 432-4368

Fax

(260) 436-6283

NPI assigned

Dec 22, 2005

Last updated

Nov 18, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Holly Thompson

Title

Ceo

Phone

(260) 207-1675

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Listed as

ENT Surgery CenterCCN 15C0001065

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Premier Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Fort Wayne, IN
  • NPI 1790709376

  Member Of

  NPD member

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian D Herr, M.D.

  • Otolaryngology Physician
  • Fort Wayne, IN
  • NPI 1700888575
  NPD
• Stephen J. Schreck, M.D.

  • Otolaryngology Physician
  • Fort Wayne, IN
  • NPI 1053313023
  NPD

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1588640353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10021 DUPONT CIRCLE CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251604",
            "telephone_number": "260-426-8117",
            "fax_number": "260-420-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 W JEFFERSON BLVD",
            "address_2": "SUITE 102",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044128",
            "telephone_number": "260-432-4368",
            "fax_number": "260-436-6283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT REALTY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-207-1675"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200138850",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew Engman
• Anna Kayleen Ennis, LCSW
• Jennifer Ennis, P.T.
• Breanna Eno, RD
• Deniya Ensley
• Entourage Health, LLC
• Envision Eye Care LLC (Envision Eye Care and Eyewear Gallery)
• Mitchell McKay Enyart
• Deborah L Enyeart, LPN
• Paula Marie Enyeart, MPT

• Ambulatory Surgical Clinic/Center in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Ambulatory Surgical Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.