Fort Wayne Cardiovascular Surgeon

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

50000046A Issued in IN

Legal business name

FORT WAYNE CARDIOVASCULAR SURGEON

Practice address

11123 Parkview Plaza Dr
Suite 202
Fort Wayne, IN 46845-1707

Phone

(260) 483-6448

Fax

(260) 373-4167

NPI assigned

Jul 10, 2006

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/Partner

Phone

(260) 483-6448

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• David T Sowden, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Fort Wayne, IN
  • NPI 1295727196

  Thoracic Surgery (Cardiothoracic Vascular Surgery)

  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790718765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 CAREW STREEET",
            "address_2": "SUITE 250",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46805",
            "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": "11123 PARKVIEW PLAZA DR",
            "address_2": "SUITE 202",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451707",
            "telephone_number": "260-483-6448",
            "fax_number": "260-373-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE CARDIOVASCULAR SURGEON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT/PARTNER",
        "authorized_official_telephone_number": "260-483-6448",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IN",
            "license": "50000046A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fort Wayne Brain & Spine Center LLC
• Fort Wayne Cardiology Corporation
• Fort Wayne Cardiology Corporation
• Fort Wayne Cardiovascular Associates
• Fort Wayne Cardiovascular Associates
• Fort Wayne Cardiovascular Surgeons, PC
• Fort Wayne Care Inc
• Fort Wayne Chiropractic, Inc.
• Fort Wayne Clubhouse, Inc
• 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 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.