Individual provider Active NPI

John Louis Bormann, MD

  • Diagnostic Radiology Physician
  • Fort Wayne, IN
National Provider Identifier
1689645707
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01042016 Issued in IN
Practice address
7910 W Jefferson Blvd Ste 108
Fort Wayne, IN 46804-4159
Phone
(260) 436-0800
Fax
(260) 483-1911
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01042016 IN Primary

Addresses

Primary practice location

7910 W Jefferson Blvd Ste 108
Fort Wayne, IN 46804-4159

Mailing address

PO Box 749495
Atlanta, GA 30374-9495
Phone (855) 963-2100

Other practice location 1

5001 US Highway 30 W Ste D
Fort Wayne, IN 46818-9701
Phone (260) 432-1568

Other identifiers 3

IdentifierTypeStateIssuer
100333820MedicaidIN
1689645707MedicaidMI
0959155MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI, OH3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20050126000624 IN Practitioner - Diagnostic Radiology 3577513639 Reassigns benefits to 8 organizations
I20090202000595 MI Practitioner - Diagnostic Radiology 3577513639 Reassigns benefits to 3 organizations
I20131017000479 OH Practitioner - Diagnostic Radiology 3577513639 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Iowa, RJ & L Carver College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry County Memorial Hospital 153 clinicians
Ella E M Brown Charitable Circle 172 clinicians
X-Ray Physicians of Shelbyville PC 43 clinicians
Pacific Imaging Associates LLC 69 clinicians
Greene County General Hospital 102 clinicians
Summit Radiology P C 101 clinicians
American Oncology Partners PA 377 clinicians

Practice addresses (Care Compare)

1000 N 16TH St
New Castle, IN 47362-4319
Phone (765) 521-0890

10320 Covington Rd
Fort Wayne, IN 46804-2549
Phone (269) 781-4271

1185 N 1000
Linton, IN 47441-5282
Phone 81284722812054

200 N Madison St
Marshall, MI 49068-1143
Phone (269) 781-4271

208 Columbus St
Hicksville, OH 43526-1250
Phone (903) 663-4800

2209 Turnberry LN
Fort Wayne, IN 46814-9354
Phone (269) 781-4271

2451 Intelliplex Dr
Shelbyville, IN 46176-8580

5001 US Hwy 30 W D
Fort Wayne, IN 46818-9701
Phone (260) 432-1568

7221 Engle Rd
Suite 220
Fort Wayne, IN 46804-2233

7910 W Jefferson Blvd
Suite 108
Fort Wayne, IN 46804-4159
Phone (260) 436-0800

916 Myrtle St
Sturgis, MI 49091-2326
Phone (269) 659-4482

Hospital & facility affiliations

  • Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017
  • Marion General Hospital Hospital, Marion, IN, CCN 150011
  • Oaklawn Hospital Hospital, Marshall, MI, CCN 230217
  • Memorial Hospital Hospital, Logansport, IN, CCN 150072
  • Kosciusko Community Hospital Hospital, Warsaw, IN, CCN 150133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01042016INMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Radiology P C Diagnostic Radiology CurrentSince Jul 1, 1994 Accepting new patients
American Oncology Partners PA Diagnostic Radiology CurrentSince Jan 2, 2025 Accepting new patients
Major Hospital Current Accepting new patients
Henry County Memorial Hospital Current Accepting new patients
Henry County Memorial Hospital CurrentSince Apr 8, 2017 Accepting new patients
X-Ray Physicians of Shelbyville PC Diagnostic Radiology CurrentSince Nov 1, 2021 Accepting new patients
Ella E M Brown Charitable Circle Diagnostic Radiology CurrentSince Oct 27, 2024 Accepting new patients
Greene County General Hospital Current Accepting new patients
Henry County Memorial Hospital CurrentSince Apr 8, 2017 Accepting new patients
Direct Imaging LLC CurrentSince Jun 16, 2017 Accepting new patients
Pacific Imaging Associates LLC Diagnostic Radiology CurrentSince Mar 24, 2025 Accepting new patients
Ella E M Brown Charitable Circle Current Accepting new patients
Gainesville Radiology Group, PC Diagnostic Radiology CurrentSince Jan 1, 2024 Accepting new patients
Greene County General Hospital Diagnostic Radiology CurrentSince Jul 31, 2025 Accepting new patients
St. Joseph Health System, LLC Past Accepting new patients
Imaging Diagnostic Center Limited Diagnostic Radiology Past Accepting new patients

Locations (25 of 33)

1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000

1524 River Pl
Ste 100
Braselton, GA 30517
Phone (770) 532-7092

3425 Buford Dr
Ste 100
Buford, GA 30519
Phone (678) 765-6060

495 Highway 400
Dahlonega, GA 30533
Phone (469) 757-1107

227 Mountain Dr
Dahlonega, GA 30533
Phone (706) 864-6136

108 Prominence Ct
Ste 120
Dawsonville, GA 30534
Phone (706) 344-6944

541 441 Historic Hwy N
Demorest, GA 30535
Phone (706) 839-4000

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

725 Jesse Jewell Pkwy SE
Ste 360
Gainesville, GA 30501
Phone (770) 539-9391

3137 Frontage Rd
Gainesville, GA 30504
Phone (770) 219-0500

1250 Jesse Jewell Pkwy SE
Ste 500
Gainesville, GA 30501
Phone (770) 531-2444

316 N Broad St
Ste 230
Winder, GA 30680

1316 E 7th St
Auburn, IN 46706
Phone (260) 925-4600

26 Six Pine Ranch Rd
Batesville, IN 47006
Phone (812) 934-5252

1120 Professional Blvd
Evansville, IN 47714
Phone (812) 471-7086

7221 Engle Rd
Ste 220
Fort Wayne, IN 46804
Phone (503) 413-7127

5001 US Highway 30 W
#D
Fort Wayne, IN 46818
Phone (808) 599-4471

7910 W Jefferson Blvd
Ste 108
Fort Wayne, IN 46804
Phone (219) 484-8830

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

5001 US Highway 30 W
Ste D
Fort Wayne, IN 46818
Phone (260) 469-8273

7900 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (219) 426-6667

720 N Lincoln St
Greensburg, IN 47240
Phone (812) 522-2349

8550 Naab Rd
Ste 205
Indianapolis, IN 46260
Phone (317) 338-6040

1185 N 1000 W
Linton, IN 47441
Phone (812) 847-2281

1000 N 16th St
New Castle, IN 47362
Phone (765) 521-0890

Organizations & group practices 29

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.

View all 29

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1689645707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749495",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749495",
            "telephone_number": "855-963-2100",
            "fax_number": "239-236-2775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 W JEFFERSON BLVD STE 108",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044159",
            "telephone_number": "260-436-0800",
            "fax_number": "260-483-1911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5001 US Highway 30 W Ste D",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468189701",
            "country_code": "US",
            "telephone_number": "260-432-1568",
            "fax_number": "260-432-4969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORMANN",
        "first_name": "JOHN",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01042016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100333820",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689645707",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0959155",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.