Organization Active NPI

Northern Indiana Orthopaedics, PC

  • Orthopaedic Surgery Physician
  • Hobart, IN
National Provider Identifier
1679601132
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
01043359A Issued in IN
Legal business name
NORTHERN INDIANA ORTHOPAEDICS, PC
Practice address
1400 S Lake Park Ave Ste 200
Hobart, IN 46342-6636
Phone
(219) 947-5606
Fax
(219) 942-4742
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Authorized official

Name
Dr. Gene Victor Fedor, M.D.NPI 1871637272
Title
President
Phone
(219) 947-5606

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)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 01043359A IN Primary

Addresses

Primary practice location

1400 S Lake Park Ave Ste 200
Hobart, IN 46342-6636

Mailing address

PO Box 306
Demotte, IN 46310-0306
Phone (219) 947-5606

Other identifiers 1

IdentifierTypeStateIssuer
000000184715OtherINBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

401 15th St SE
Ste 3
Demotte, IN 46310
Phone (219) 750-9465

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1679601132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306",
            "city": "DEMOTTE",
            "state": "IN",
            "postal_code": "463100306",
            "telephone_number": "219-947-5606",
            "fax_number": "219-942-4742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S LAKE PARK AVE STE 200",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426636",
            "telephone_number": "219-947-5606",
            "fax_number": "219-942-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN INDIANA ORTHOPAEDICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "FEDOR",
        "authorized_official_first_name": "GENE",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-947-5606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "01043359A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000184715",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hobart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.