NPIMap

Organization Active NPI

Northeast Obstetrics & Gynecology, LLC

  • Obstetrics & Gynecology Physician
  • Fort Wayne, IN
National Provider Identifier
1831354471
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
NORTHEAST OBSTETRICS & GYNECOLOGY, LLC
Practice address
2414 E State Blvd
Suite 101
Fort Wayne, IN 46805-4760
Phone
(260) 422-7455
Fax
(260) 422-0086
NPI assigned
Jul 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

Name
Tami A Furniss
Title
Business Manager
Phone
(260) 426-7755

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

2414 E State Blvd
Suite 101
Fort Wayne, IN 46805-4760

Mailing address

2414 E State Blvd
Suite 101
Fort Wayne, IN 46805-4760
Phone (260) 422-7455

National Provider Directory

National Provider Directory
Tax ID family
Northeast Obstetrics Gynecology LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1831354471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2414 E STATE BLVD",
            "address_2": "SUITE 101",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054760",
            "telephone_number": "260-422-7455",
            "fax_number": "260-422-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2414 E STATE BLVD",
            "address_2": "SUITE 101",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054760",
            "telephone_number": "260-422-7455",
            "fax_number": "260-422-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST OBSTETRICS & GYNECOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-23",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "FURNISS",
        "authorized_official_first_name": "TAMI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "260-426-7755"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.