Three Rivers Anesthesia, LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

THREE RIVERS ANESTHESIA, LLC

Practice address

7956 W. Jefferson Blvd.
Fort Wayne, IN 46804

Phone

(765) 284-0493

Fax

(765) 284-2434

NPI assigned

Dec 11, 2006

Last updated

Aug 22, 2020By 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

Dr. Mary Jennifer Yao Ong Phuong, M.D.NPI 1346292604

Title

Owner

Phone

(765) 284-0493

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Jennifer Yao Ong Phuong, MD

  • Anesthesiology Physician
  • Fort Wayne, IN
  • NPI 1346292604
  NPD (past) Authorized official

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760542468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N GRANVILLE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473032110",
            "telephone_number": "765-284-0493",
            "fax_number": "765-284-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7956 W. JEFFERSON BLVD.",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46804",
            "telephone_number": "765-284-0493",
            "fax_number": "765-284-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHUONG",
        "authorized_official_first_name": "MARY JENNIFER",
        "authorized_official_middle_name": "YAO ONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-284-0493",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Thornton, PMHNP-BC
• Tara Thornton, PHARM D
• Allison A Thorpe, CNM
• Raja V Thotakura, M.D.
• Three Rivers Ambulance Authority
• Three Rivers Dermatology, LLC (Three Rivers Dermatology)
• Three Rivers Home Car Services LLC
• Three Rivers Medical Associates, LLC
• Three Rivers Radiology, LLC
• Three Rivers Surgical Associates

• Anesthesiology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Anesthesiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.