Fort Wayne Cardiology Corporation

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

FORT WAYNE CARDIOLOGY CORPORATION

Practice address

11558 Sr 111
Paulding, OH 45879

Phone

(260) 481-4700

Fax

(260) 481-4808

NPI assigned

Dec 20, 2005

Reactivated

Oct 11, 2007

Last updated

Oct 7, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

FORT WAYNE CARDIOLOGY CORPORATIONAs reported in NPPES

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

Ceo

Phone

(260) 481-4700

Specialties & licenses 3

Addresses

Other identifiers 2

Tax ID family

Fort Wayne Cardiology C2 organizations share this tax ID, including this one

Part of

Fort Wayne Cardiology C

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fort Wayne Cardiology Corporation

  • Cardiovascular Disease Physician
  • Hicksville, OH
  • NPI 1730165242
  NPD tax ID

Practitioners 3

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.

• Raymond E Dusman Jr., MD

  • Cardiovascular Disease Physician
  • Fort Wayne, IN
  • NPI 1568464972
  Authorized official Same address or phone
• Charles F Presti, MD

  • Cardiovascular Disease Physician
  • Fort Wayne, IN
  • NPI 1871585042
  NPD (past)
• T Eric White, MD

  • Interventional Cardiology Physician
  • Fort Wayne, IN
  • NPI 1235121104

  Cardiovascular Disease

  NPD (past)

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223337600000",
    "number": "1669458733",
    "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": "11558 SR 111",
            "city": "PAULDING",
            "state": "OH",
            "postal_code": "45879",
            "telephone_number": "260-481-4700",
            "fax_number": "260-481-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE CARDIOLOGY CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FORT WAYNE CARDIOLOGY CORPORATION",
        "enumeration_date": "2005-12-20",
        "last_updated": "2008-10-07",
        "deactivation_date": "2007-08-09",
        "reactivation_date": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "DUSMAN",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-481-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200425420M",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CK8615",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Favorite
• Kristina Figgins, COTA/L
• Larry Brent Fishbaugh, D.O.
• Dennis Michael Fitzgerald
• Rose Foltz
• Jody L Fraley
• Gardens at Paulding Operating Company, LLC (The Gardens at Paulding)
• Gardens at Paulding Operating Company, LLC (The Gardens at Paulding)
• Roger Lee Gasser
• Elizabeth Gilbert

• Cardiovascular Disease Physician in Paulding, OH
• Providers in Paulding, OH by specialty
• Cardiovascular Disease Physician in Ohio

• 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.