Active NPI
Daniel H Nolan, MD
- Pain Medicine (Anesthesiology) Physician
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- 01061124A
- Practice address
- 608 Union Chapel Rd
Fort Wayne, IN 46845-9357 - Phone
- (260) 387-0450
- NPI assigned
- Nov 1, 2006
- Last updated
- Oct 25, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 74402-20 | WI | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 74402-20 | WI | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 01061124A | IN | Primary |
Addresses
Primary practice location
608 Union Chapel Rd
Fort Wayne, IN 46845-9357
Mailing address
608 Union Chapel Rd
Fort Wayne, IN 46845-9357
Phone (260) 387-0450
Other practice location 1
N2950 State Road 67
Lake Geneva, WI 53147-2655
Phone (262) 245-0535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pain Management
- Education
- Indiana University School of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Health System Corporation
Practice addresses (Care Compare)
N2950 State Rd
Suite 67
Lake Geneva, WI 53147-2655
Phone (262) 245-0535
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74402-20 | WI | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health System Corporation | Current | Accepting new patients | |
| Professional Emergency Physicians PC | Current | Accepting new patients |
Locations
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
608 Union Chapel Rd
Fort Wayne, IN 46845
Phone (260) 482-4440
1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868
N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535
Interoperability endpoints
- dnolan73742@direct.mhemail.org
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba MHS Physician Services
- Multi-Specialty Clinic/Center
- Janesville, WI
- NPI 1598718603
-
dba Mercy Walworth Hospital and Medical Center
- Critical Access Hospital
- Lake Geneva, WI
- NPI 1699728550
-
- Interventional Pain Medicine Physician
- Fort Wayne, IN
- NPI 1164661054
-
- Emergency Medicine Physician
- Fort Wayne, IN
- NPI 1144215096
-
dba Mercy Hospital Janesville
- General Acute Care Hospital
- Janesville, WI
- NPI 1093768962
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Mercy Walworth Hospital and Medical Center
- Critical Access Hospital
- Lake Geneva, WI
- NPI 1699728550
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729814400000",
"number": "1912084369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "608 UNION CHAPEL RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468459357",
"telephone_number": "260-387-0450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "608 UNION CHAPEL RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468459357",
"telephone_number": "260-387-0450"
}
],
"practiceLocations": [
{
"address_1": "N2950 State Road 67",
"address_purpose": "LOCATION",
"city": "Lake Geneva",
"state": "WI",
"postal_code": "531472655",
"country_code": "US",
"telephone_number": "262-245-0535",
"fax_number": "262-245-2248",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NOLAN",
"first_name": "DANIEL",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2024-10-25",
"certification_date": "2024-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WI",
"license": "74402-20",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "WI",
"license": "74402-20",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "IN",
"license": "01061124A",
"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 Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.