Northeast Indiana Urology, P.C.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

NORTHEAST INDIANA UROLOGY, P.C.

Practice address

2217 Dubois Dr
Warsaw, IN 46580-3212

Phone

(260) 436-6667

Fax

(260) 469-7437

NPI assigned

Feb 4, 2008

Last updated

Dec 10, 2012By 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

John Brinkman, M.D.

Title

President

Phone

(260) 436-6667

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355097600000",
    "number": "1821276627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 E DUPONT RD STE 100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251609",
            "telephone_number": "260-436-6667",
            "fax_number": "260-469-7437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 DUBOIS DR",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803212",
            "telephone_number": "260-436-6667",
            "fax_number": "260-469-7437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST INDIANA UROLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2012-12-10",
        "status": "A",
        "authorized_official_last_name": "BRINKMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-436-6667",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100081380",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura B Newman
• Khoa Ngo, PHARMD
• Luan Nhan Nguyen, MD
• Hope Niemier
• Emma Kathryn Nifong
• Maria Nunez, MSED
• Jeffrey Douglas O'Dell, M.D.
• Brian Gerrit Ockerse, M.D.
• Alyssa Ocran
• Emily Oden

• Durable Medical Equipment & Medical Supplies in Warsaw, IN
• Providers in Warsaw, IN by specialty
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2012; 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.