SURGERY ONE ANESTHESIA, LLC (NPI# 1144724402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144724402 |
| Entity Type | Organization |
| Organization Name | SURGERY ONE ANESTHESIA, LLC |
| Practice Address |
5050 N Clinton St Fort Wayne IN 46825-5886 |
| Mailing Address |
5052 N Clinton St Fort Wayne IN 46825-5822 |
| Practice Telephone | 2604848551 |
| Practice Fax Number | 2604825060 |
| Mailing Telephone | 2604848551 |
| Mailing Fax Number | 2604088014 |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2018-03-21 |
| Authorized Official Name | MRS. BARBARA JANICE HATHAWAY (CREDENTIALING OFFICER) |
| Authorized Official Telephone | 2604082203 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11130 Parkview Circle Dr, Fort Wayne, IN 468451735 | 2606725000 | |
| 11420 Parkview Circle Dr, Fort Wayne, IN 468451729 | 2604825194 |
| Street Address |
5050 N CLINTON ST |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46825-5886 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144228529 | Scott Davis | Anesthesiology | 5050 N Clinton St, Fort Wayne, IN 46825-5886 | 2005-07-11 |
| 1477179737 | Mirsad Maglajlic | Nurse Anesthetist, Certified Registered | 5050 N Clinton St, Fort Wayne, IN 46825-5886 | 2020-06-23 |
| 1053937961 | Kay Elizabeth Brown | Registered Nurse | 5050 N Clinton St, Fort Wayne, IN 46825-5886 | 2020-06-17 |
| 1831714716 | Raelene Marie Lamott | Licensed Practical Nurse | 5050 N Clinton St, Fort Wayne, IN 46825-5886 | 2020-06-16 |
| 1982184701 | Angela R Kesler | Physical Therapist | 5050 N Clinton St, Fort Wayne, IN 46825-5886 | 2018-08-21 |
| 1912485947 | Kaley Alison Weber | Physician Assistant | 5050 N Clinton St, Fort Wayne, IN 46825-5886 | 2018-08-01 |
| 1275019341 | Cayla Marie Vorndran | Physician Assistant | 5050 N Clinton St, Fort Wayne, IN 46825-5886 | 2018-07-12 |
| 1629560370 | Aaron Michael Lewis | Nurse Anesthetist, Certified Registered | 5050 N Clinton St, Fort Wayne, IN 46825-5886 | 2018-05-30 |
| 1235631557 | Samuel Vincent Dismuke | Physician Assistant | 5050 N Clinton St, Fort Wayne, IN 46825-5886 | 2018-03-02 |
| 1881100758 | Brittany Hallis | Specialist/Technologist | 5050 N Clinton St, Fort Wayne, IN 46825-5886 | 2017-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
| 1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
| Find all providers in zip 46825 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265858765 | James Edward Luckey | Anesthesiology | 4701 Covington Rd, Suite 18, Fort Wayne, IN 46804-5072 | 2014-03-09 |
| 1811324411 | Willliam Richard Hall | Anesthesiology | 8721 Fortuna Way, Fort Wayne, IN 46815-5724 | 2013-09-27 |
| 1760542468 | Three Rivers Anesthesia, LLC | Anesthesiology | 7956 W. Jefferson Blvd., Fort Wayne, IN 46804 | 2006-12-11 |
| 1588746838 | Andrea Waingold | Anesthesiology | 11141 Parkview Plaza Dr Ste 200, Fort Wayne, IN 46845-1714 | 2006-10-19 |
| 1487755534 | Kathryn Carboneau | Anesthesiology | 11115 Pine Bank Ct, Fort Wayne, IN 46845-1839 | 2006-09-25 |
| 1497788848 | Il-sung Kwak | Anesthesiology | 2222 Timberbrook Trl, Fort Wayne, IN 46845-9530 | 2006-07-09 |
| 1760427686 | Andrzej S. Waskiel | Anesthesiology | 10315 Dawsons Creek Blvd Ste Ab, Fort Wayne, IN 46825-1912 | 2006-06-17 |
| 1992745806 | Muhammod Ahmad | Anesthesiology | 1942 E Dupont Rd Ste A, Fort Wayne, IN 46825-1582 | 2006-06-08 |
| 1346212487 | Glenn Batiller | Anesthesiology | 11518 Tillbury Cv, Fort Wayne, IN 46845-2138 | 2006-02-03 |
| 1457336539 | Jun Wang | Anesthesiology | 10351 Dawsons Creek Blvd, Ste D, Fort Wayne, IN 46825-1904 | 2005-12-12 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46825 |
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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.