Active NPI
Dupont OB-GYN
- Obstetrics & Gynecology Physician
- Fort Wayne, IN
National Provider Identifier
1669487005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 01035629
- Legal business name
- DUPONT OB-GYN
- Practice address
- 11123 Parkview Plaza Dr
Suite 204
Ft Wayne, IN 46845 - Phone
- (260) 490-6260
- Fax
- (260) 490-6261
- NPI assigned
- Jul 31, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rosemary Leitch, MD FACOG
- Title
- Owner
- Phone
- (260) 490-6260
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 01035629 | IN | Primary |
Addresses
Primary practice location
11123 Parkview Plaza Dr
Suite 204
Ft Wayne, IN 46845
Mailing address
11123 Parkview Plaza Dr
Suite 204
Ft Wayne, IN 46845
Phone (260) 490-6260
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000093382 | Other | IN | ANTHEM BCBS |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Specialist
- Fort Wayne, IN
- NPI 1609095231
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1197331200000",
"number": "1669487005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11123 PARKVIEW PLAZA DR",
"address_2": "SUITE 204",
"city": "FT WAYNE",
"state": "IN",
"postal_code": "46845",
"telephone_number": "260-490-6260",
"fax_number": "260-490-6261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11123 PARKVIEW PLAZA DR",
"address_2": "SUITE 204",
"city": "FT WAYNE",
"state": "IN",
"postal_code": "46845",
"telephone_number": "260-490-6260",
"fax_number": "260-490-6261"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DUPONT OB-GYN",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-31",
"last_updated": "2007-12-11",
"status": "A",
"authorized_official_last_name": "LEITCH",
"authorized_official_first_name": "ROSEMARY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "260-490-6260",
"authorized_official_credential": "MD FACOG"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": "IN",
"license": "01035629",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000093382",
"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 Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.