Fort Wayne Orthopaedics, LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

50002482 Issued in IN

Legal business name

FORT WAYNE ORTHOPAEDICS, LLC

Practice address

1302 Minnich Rd
New Haven, IN 46774-2052

Phone

(260) 436-8686

Fax

(260) 432-5075

NPI assigned

Aug 13, 2010

Organization subpart

No

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

Authorized official

Name

Jerald L Cooper, M.D.

Title

President

Phone

(260) 436-8686

Specialties & licenses 8

Addresses

Other identifiers 1

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

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281657600000",
    "number": "1609181759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2526",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468012526",
            "telephone_number": "260-436-8686",
            "fax_number": "260-432-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 MINNICH RD",
            "city": "NEW HAVEN",
            "state": "IN",
            "postal_code": "467742052",
            "telephone_number": "260-436-8686",
            "fax_number": "260-432-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE ORTHOPAEDICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-13",
        "last_updated": "2010-08-13",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "JERALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-436-8686",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "50002482",
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "IN",
            "license": "50002482",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "IN",
            "license": "50002482",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IN",
            "license": "50002482",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "IN",
            "license": "50002482",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "50002482",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "IN",
            "license": "50002482",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "50002482",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100210470",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Ehle
• Robert P Ellison
• Laura Faucett, APRN-FNP
• Joel D. Feeman, D.C.
• Andrew Daegan Fogarty
• Megan Brianna Fuelling, OD
• Brandon Galbraith, D.C.
• Stacy Gallegos, LMT
• Genesis Eldercare Physicians Services LLC
• Lindzie Ann-Louise Gibson, RPH

• Orthopaedic Surgery Physician in New Haven, IN
• Providers in New Haven, IN by specialty
• Orthopaedic Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; 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.