George H Kinnebrew, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

01032457 Issued in IN

Practice address

3707 New Vision Dr
Fort Wayne, IN 46895-5602

Phone

(260) 484-0850

Fax

(260) 484-5919

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992711576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451702",
            "telephone_number": "260-484-0850",
            "fax_number": "260-484-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468955602",
            "telephone_number": "260-484-0850",
            "fax_number": "260-484-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEBREW",
        "first_name": "GEORGE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01032457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Winsome King
• Kingston Residence of Fort Wayne, LLC
• David A Kiningham, M.ED
• Emeri C Kinnamon, NP
• Robert James Kinne, M.D.
• Cassandra Kinney, AU.D.
• Kristen Kinnie, RBT
• Lauren Brianne Kinniry
• Thomas A. Kintanar, MD
• Sadie S. Kintz, NP

• Diagnostic Radiology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Diagnostic Radiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.