Fort Wayne Cardiovascular Surgeons, PC

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

Legal business name

FORT WAYNE CARDIOVASCULAR SURGEONS, PC

Practice address

1818 Carew St
Suite 250
Fort Wayne, IN 46805-4788

Phone

(260) 483-6448

Fax

(260) 373-4167

NPI assigned

Jan 9, 2006

Last updated

Oct 22, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Douglas L Gray, MD

Title

President

Phone

(260) 483-6448

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1679551741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 CAREW ST",
            "address_2": "SUITE 250",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054788",
            "telephone_number": "260-483-6448",
            "fax_number": "260-373-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 CAREW ST",
            "address_2": "SUITE 250",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054788",
            "telephone_number": "260-483-6448",
            "fax_number": "260-373-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE CARDIOVASCULAR SURGEONS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-483-6448",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "C15472",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fort Wayne Cardiology Corporation
• Fort Wayne Cardiology Corporation
• Fort Wayne Cardiovascular Associates
• Fort Wayne Cardiovascular Associates
• Fort Wayne Cardiovascular Surgeon
• Fort Wayne Care Inc
• Fort Wayne Chiropractic, Inc.
• Fort Wayne Clubhouse, Inc (The Carriage House)
• Fort Wayne Community Schools
• Fort Wayne Community Schools

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.

Verify at the official NPI Registry.