COLON-RECTAL SURGEONS OF FORT WAYNE, PC (NPI# 1104026657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104026657 |
| Entity Type | Organization |
| Organization Name | COLON-RECTAL SURGEONS OF FORT WAYNE, PC |
| Practice Address |
7900 W Jefferson Blvd Suite 302 Fort Wayne IN 46804-4128 |
| Practice Telephone | 2604351900 |
| Practice Fax Number | 2604351800 |
| Mailing Telephone | 2604351900 |
| Mailing Fax Number | 2604351800 |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2007-07-23 |
| Authorized Official Name | LISA HAUSCHILD (BUSINESS MANAGER) |
| Authorized Official Telephone | 2606093734 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208C00000X | Colon & Rectal Surgery | IN | Allopathic & Osteopathic Physicians |
| Street Address |
7900 W JEFFERSON BLVD SUITE 302 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-4128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497744437 | Valerie D. Stogdill | Physician Assistant | 7900 W Jefferson Blvd, Suite 201, Fort Wayne, IN 46804-4128 | 2005-10-20 |
| 1922556752 | Carole E. Slater | Registered Nurse | 7900 W Jefferson Blvd, Suite 201, Fort Wayne, IN 46804-4128 | 2016-09-21 |
| 1144694464 | Kendall S. Ray | Dietitian, Registered | 7900 W Jefferson Blvd, Suite 201, Fort Wayne, IN 46804-4128 | 2015-11-24 |
| 1548529084 | Beverly L. Mauger | Nurse Practitioner | 7900 W Jefferson Blvd, Suite 304, Fort Wayne, IN 46804-4128 | 2012-05-03 |
| 1679857502 | Sara J Nevil | Nurse Practitioner | 7900 W Jefferson Blvd, Suite 304, Fort Wayne, IN 46804-4128 | 2011-10-11 |
| 1043592033 | Kelly A Anderson | Nurse Practitioner | 7900 W Jefferson Blvd, Suite 304, Fort Wayne, IN 46804-4128 | 2011-09-15 |
| 1336460161 | Charles Lee Copeland | Physician Assistant | 7900 W Jefferson Blvd, Suite 304, Fort Wayne, IN 46804-4128 | 2010-06-16 |
| 1679805048 | Michelle Ann Parra | Nurse Practitioner | 7900 W Jefferson Blvd, Ste 304, Fort Wayne, IN 46804-4128 | 2010-02-09 |
| 1861624587 | Benjamin P Merchant | Physical Therapist | 7900 W Jefferson Blvd, Suite 304, Fort Wayne, IN 46804-4128 | 2009-08-13 |
| 1134358005 | Justin D. Brown | Nurse Practitioner | 7900 W Jefferson Blvd, Suite 201, Fort Wayne, IN 46804-4128 | 2009-07-13 |
| 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 | 208C00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Colon & Rectal Surgery |
| A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Colon and Rectal Surgery, 2007. http://www.abcrs.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Colon and Rectal Surgery. Colon and rectal surgeons have the expertise to diagnose and often manage anorectal conditions such as hemorrhoids, fissures (painful tears in the anal lining), abscesses and fistulae (infections located around the anus and rectum) in the office setting. They also treat problems of the intestine and colon, and perform endoscopic procedures to evaluate and treat problems such as cancer, polyps (precancerous growths) and inflammatory conditions. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
| 1568795409 | Center for Colon and Rectal Care LLC | Colon & Rectal Surgery | 12012 Wood Glen Dr, Fort Wayne, IN 46814-4515 | 2009-09-10 |
| 1740689207 | Associated Surgeons & Physicians, LLC | Colon & Rectal Surgery | 7910 W Jefferson Blvd, Suite 305, Fort Wayne, IN 46804-4159 | 2014-08-20 |
| 1639451578 | Vemuru Sunil Kumar Reddy | Colon & Rectal Surgery | 11104 Parkview Circle Dr Ste 320, Fort Wayne, IN 46845-1672 | 2011-09-16 |
| 1598961393 | Joshua Michael Wallet | Colon & Rectal Surgery | 7988 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2007-06-27 |
| 1265636138 | Charles Lamont Morrison | Colon & Rectal Surgery | 7988 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2007-06-13 |
| 1477676658 | Hisham S Elhassan | Colon & Rectal Surgery | 11141 Parkview Plaza Dr, Suite 310, Fort Wayne, IN 46845-1701 | 2007-04-10 |
| 1346336575 | Glenn L Goldstein | Colon & Rectal Surgery | 7900 W Jefferson Blvd, Suite 302, Fort Wayne, IN 46804-4128 | 2006-10-05 |
| 1821184052 | Nadine L Floyd | Colon & Rectal Surgery | 7988 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2006-10-05 |
| 1912998014 | Northeast Indiana Colon Rectal Surgeons PC | Colon & Rectal Surgery | 11141 Parkview Plaza Dr, Suite 310, Fort Wayne, IN 46845-1701 | 2005-10-31 |
| 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.