JONATHAN T SHIRAZI (NPI# 1124330857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1124330857 |
Entity Type | Individual |
Full Name | JONATHAN T SHIRAZI |
Credential | M.D. |
Practice Address |
11108 Parkview Circle Dr Fort Wayne IN 46845 |
Mailing Address |
11109 Parkview Plaza Drive Mailbox 117 Fort Wayne IN 46845 |
Practice Telephone | 2602665700 |
Practice Fax Number | 2602665910 |
Mailing Telephone | 2602668210 |
Enumeration Date | 2010-07-10 |
Last Update Date | 2020-09-23 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207R00000X | Internal Medicine | 01072142A | IN | Allopathic & Osteopathic Physicians |
N | 207R00000X | Internal Medicine | 11015529A | IN | Allopathic & Osteopathic Physicians |
Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
01072142A | IN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 201101920 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
1001 W 10th St # M200, Indianapolis, IN 462022859 | 3176564260 | 3176302667 |
Street Address |
11108 PARKVIEW CIRCLE DR |
City | FORT WAYNE |
State | IN |
Zip Code | 46845 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710986443 | Lawrence E Gering | Internal Medicine | 11108 Parkview Circle Dr, Fort Wayne, IN 46845-1730 | 2005-07-15 |
1477106326 | Ashika R Thanju | Registered Nurse | 11108 Parkview Circle Dr, Fort Wayne, IN 46845-1730 | 2019-07-19 |
1003469925 | Shannon L Decker | Registered Nurse | 11108 Parkview Circle Dr, Fort Wayne, IN 46845-1730 | 2019-07-19 |
1023596350 | Maryam Noureldin | Pharmacist | 11108 Parkview Circle Dr, Fort Wayne, IN 46845-1730 | 2018-07-30 |
1831676576 | Rosanne Wuthrich | Pharmacist | 11108 Parkview Circle Dr, Fort Wayne, IN 46845-1730 | 2018-07-25 |
1720579329 | Anne Marie Dietz | Dietitian, Registered | 11108 Parkview Circle Dr, Fort Wayne, IN 46845 | 2018-05-20 |
1760998843 | Amanda M Gilbert | Registered Nurse | 11108 Parkview Circle Dr, Fort Wayne, IN 46845-1730 | 2017-12-27 |
1336682723 | Kaitlyn D Brita | Registered Nurse | 11108 Parkview Circle Dr, Fort Wayne, IN 46845-1730 | 2016-12-02 |
1467853523 | Kayla Burns | Physician Assistant | 11108 Parkview Circle Dr, Suite 5100, Fort Wayne, IN 46845-1730 | 2014-09-09 |
1649688870 | Heather Kountouris | Pharmacist | 11108 Parkview Circle Dr, Fort Wayne, IN 46845-1730 | 2014-07-31 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
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Taxonomy Code | 207RC0000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Cardiovascular Disease |
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780919886 | Heart Care LLC | Internal Medicine | 7806 W Jefferson Blvd, Suite D, Fort Wayne, IN 46804-4180 | 2009-10-07 |
1003078312 | Dustin M Thomas | Internal Medicine | 11108 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2008-06-27 |
1174625065 | Baltes Cardiology | Internal Medicine | 821 Broadway, Fort Wayne, IN 46802-2107 | 2006-09-02 |
1922117571 | Louis Alfred Lopez | Internal Medicine | 604 W Berry St, Fort Wayne, IN 46802-2106 | 2006-08-29 |
1821068511 | Subhash Reddy | Internal Medicine | 7806 W Jefferson Blvd Ste D, Fort Wayne, IN 46804-4180 | 2006-01-25 |
1215917844 | Gary A. Hambel | Internal Medicine | 11108 Parkview Circle Dr., Fort Wayne, IN 46845-1730 | 2006-01-19 |
1932199627 | J. Rod Gimbel | Internal Medicine | 7910 W Jefferson Blvd Ste 120, Fort Wayne, IN 46804-4159 | 2005-10-25 |
1568464972 | Raymond E Dusman Jr. | Internal Medicine | 1819 Carew St, Fort Wayne, IN 46805-4705 | 2005-08-15 |
1427058825 | Motaz Shaher | Internal Medicine | 7916 W Jefferson Blvd, Fort Wayne, IN 46804 | 2005-07-28 |
1710986443 | Lawrence E Gering | Internal Medicine | 11108 Parkview Circle Dr, Fort Wayne, IN 46845-1730 | 2005-07-15 |
Find all providers in FORT WAYNE |
City | FORT WAYNE |
Zip Code | 46845 |
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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.