IAN R NELSON (NPI# 1043440852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043440852 |
| Entity Type | Individual |
| Full Name | IAN R NELSON |
| Credential | M.D. |
| Practice Address |
7601 W Jefferson Blvd Fort Wayne IN 46804-4133 |
| Mailing Address |
P.o. Box 2526 Fort Wayne IN 46801-2526 |
| Practice Telephone | 2604368686 |
| Practice Fax Number | 2604368585 |
| Mailing Telephone | 2604368686 |
| Mailing Fax Number | 2604368585 |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2016-11-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 01075426A | IN | Allopathic & Osteopathic Physicians |
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
01075426A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201291590 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932553328 | Ian Michael Nelson | Student in an Organized Health Care Education/Training Program | 1600 Sw Archer Rd, Suite 4102, Gainesville, FL 32610-3003 | 2016-04-21 |
| 1063887735 | Ian Nelson | Adult Companion | 847 Ne 19th Ave, Suite 100., Portland, OR 97232-2684 | 2015-12-07 |
| 1275886426 | Ian Nelson | Psychologist | 1870 Leonard St Ne, Grand Rapids, MI 49505-5650 | 2012-10-24 |
| Street Address |
7601 W JEFFERSON BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-4133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497758429 | Fort Wayne Orthopaedics LLC | Orthopaedic Surgery | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2005-05-23 |
| 1801456553 | Elizabeth Schaefer | Specialist/Technologist | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2019-06-15 |
| 1417514480 | Courtney Mangan | Nurse Practitioner | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2019-05-24 |
| 1881177798 | Lindsey M. Hertenstein | Registered Nurse | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2018-09-07 |
| 1912407099 | Heather Korte | Registered Nurse | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2018-02-15 |
| 1902314958 | John Grimshaw | Registered Nurse | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2018-01-11 |
| 1053836882 | Alex Villavicencio | Nurse Practitioner | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2017-08-14 |
| 1841721735 | Abbey K. Bunnell | Nurse Practitioner | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2017-03-23 |
| 1093256950 | Jessica A. Wiedemann | Nurse Practitioner | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2017-03-13 |
| 1245786672 | Abigail Vanlaningham | Physician Assistant | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2016-08-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861774838 | Paul Arthur Reszel | Orthopaedic Surgery | 1618 Autumn Run, Fort Wayne, IN 46845-8884 | 2011-09-15 |
| 1073505301 | William H Couch | Orthopaedic Surgery | 5050 N Clinton Street, Fort Wayne, IN 46825 | 2005-08-23 |
| 1366445421 | Ronald G Caldwell | Orthopaedic Surgery | 413 E Jefferson Blvd, Matthew 25 Health and Dental Clinic, Fort Wayne, IN 46802-3201 | 2005-05-23 |
| 1255750352 | Fort Wayne Orthopaedics, LLC | Orthopaedic Surgery | 800 Broadway, Ste 215, Fort Wayne, IN 46802-2149 | 2014-04-16 |
| 1649534256 | James Michael Danias | Orthopaedic Surgery | 5050 N Clinton St, Fort Wayne, IN 46825-5886 | 2012-06-28 |
| 1326311481 | Phillip Craig Penny I | Orthopaedic Surgery | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2012-02-20 |
| 1427345982 | Christopher N Johnson | Orthopaedic Surgery | 5050 N Clinton St, Fort Wayne, IN 46825-5886 | 2011-07-06 |
| 1043506694 | John Paul Magno Manalo | Orthopaedic Surgery | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2011-06-22 |
| 1487959649 | Kevin John Leffers | Orthopaedic Surgery | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2011-01-20 |
| 1871808923 | Fort Wayne Orthopaedics, LLC | Orthopaedic Surgery | 2512 E Dupont Rd, Suite 110, Fort Wayne, IN 46825-1609 | 2010-08-13 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.