Individual provider Active NPI

Connor Holcomb

  • Obstetrics & Gynecology Physician
  • Fort Wayne, IN
National Provider Identifier
1679213078
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
01098618A Issued in IN
Practice address
7988 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone
(260) 432-4400
Fax
(260) 432-2723
NPI assigned
Apr 1, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 01098618A IN Primary

Addresses

Primary practice location

7988 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Mailing address

2518 E Dupont Rd
Fort Wayne, IN 46825-1675
Phone (260) 432-4400

Other practice location 1

2518 E DuPont Rd
Fort Wayne, IN 46825-1675
Phone (260) 432-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260429002868 IN Practitioner - Obstetrics/Gynecology 4587131370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2518 E Dupont Rd
Fort Wayne, IN 46825-1675

6619 Brotherhood Way
Fort Wayne, IN 46825-4226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4351049414APP22MIMDObstetrics & Gynecology Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1679213078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 E DUPONT RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251675",
            "telephone_number": "260-432-4400",
            "fax_number": "260-432-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7988 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-432-4400",
            "fax_number": "260-432-2723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2518 E DuPont Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468251675",
            "country_code": "US",
            "telephone_number": "260-432-4400",
            "fax_number": "260-432-2723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLCOMB",
        "first_name": "CONNOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-01",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01098618A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.