QHG of Fort Wayne Company LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

QHG OF FORT WAYNE COMPANY LLC

Practice address

1415 Flaxmill Rd
Huntington, IN 46750-8806

Phone

(260) 359-1250

NPI assigned

Jun 3, 2006

Organization subpart

No

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

Authorized official

Name

Debbie T Brewer

Title

Director of Provider Enrollment

Phone

(615) 465-7626

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223942400000",
    "number": "1952349896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 COMMERCE WAY",
            "address_2": "SUITE 180",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 FLAXMILL RD",
            "city": "HUNTINGTON",
            "state": "IN",
            "postal_code": "467508806",
            "telephone_number": "260-359-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QHG OF FORT WAYNE COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2008-10-14",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "615-465-7626"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200230770C",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Plasterer
• June Hazel Pollydore, M.D.
• Riley Powell
• Jenna M Prather, MA
• Professional Emergency Physicians Inc
• QHG of Fort Wayne, Inc.
• Christopher Rakoczy, DPT
• Anil V Rao, MD/OBGYN
• Doris Jean Rapp, PH.D.
• Annalee Lakie Rawley, LMFT

• General Practice Physician in Huntington, IN
• Providers in Huntington, IN by specialty
• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.