NPIMap

Organization Active NPI

Fort Wayne Cardiology Corporation

  • Cardiovascular Disease Physician
  • Fort Wayne, IN
National Provider Identifier
1609852292
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
FORT WAYNE CARDIOLOGY CORPORATION
Practice address
1819 Carew St
Fort Wayne, IN 46805-4705
Phone
(260) 481-4700
Fax
(260) 481-4808
NPI assigned
Dec 16, 2005
Last updated
Oct 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

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

Authorized official

Name
Dr. Raymond Dusman, M.D.NPI 1568464972
Title
MD Practitioner
Phone
(260) 481-4700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X NU
Interventional Cardiology Physician 207RI0011X NU

Addresses

Primary practice location

1819 Carew St
Fort Wayne, IN 46805-4705

Mailing address

PO Box 11829
Fort Wayne, IN 46861-1829
Phone (260) 481-4700

Other identifiers 2

IdentifierTypeStateIssuer
CK6996OtherINRR MEDICARE
200425420AMedicaidIN

National Provider Directory

National Provider Directory

Locations

1819 Carew St
Fort Wayne, IN 46805
Phone (260) 481-4810

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

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": "1223337600000",
    "number": "1609852292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11829",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468611829",
            "telephone_number": "260-481-4700",
            "fax_number": "260-481-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 CAREW ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054705",
            "telephone_number": "260-481-4700",
            "fax_number": "260-481-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE CARDIOLOGY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-16",
        "last_updated": "2008-10-07",
        "status": "A",
        "authorized_official_last_name": "DUSMAN",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "MD PRACTITIONER",
        "authorized_official_telephone_number": "260-481-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CK6996",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200425420A",
            "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 7, 2008; 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.