DR. LORETTO GLYNN (NPI# 1235111014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235111014 |
| Entity Type | Individual |
| Full Name | DR. LORETTO GLYNN |
| Credential | M.D. |
| Practice Address |
11115 Parkview Plaza Dr Fort Wayne IN 46845-1701 |
| Practice Telephone | 2602665400 |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2020-05-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
35914 | OK | Allopathic & Osteopathic Physicians |
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
036-083709 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6151 S Yale Ave Ste 1305, Tulsa, OK 741361907 | 9184949450 | 9184949437 |
| Street Address |
11115 PARKVIEW PLAZA DR |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-1701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932106317 | Jayesh P Patel | Pediatrics | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2005-06-30 |
| 1003473307 | Angela Booth | Registered Nurse | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2019-05-22 |
| 1942696356 | Sarah E Brandenberger | Genetic Counselor, MS | 11115 Parkview Plaza Dr, Attn: Sarah King, Fort Wayne, IN 46845-1701 | 2015-04-13 |
| 1588058739 | Halie Hoang Kudumula | Nurse Practitioner | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2015-03-26 |
| 1639425291 | Lisa Marie Piwoszkin | Pediatrics | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2012-07-31 |
| 1235424482 | Christen A Merkler | Nurse Practitioner | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2011-06-16 |
| 1730400714 | Rachel Miller | Registered Nurse | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2010-06-14 |
| 1225250129 | Ravi Kudumula | Pediatrics | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2007-05-02 |
| 1104950799 | Win Boon | Pediatrics | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2007-03-15 |
| 1700984002 | Emily J Deneve | Nurse Practitioner | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2006-09-20 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 46845 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588664932 | Paul T. Stockmann | Surgery | 11123 Parkview Plaza Dr Ste 200, Fort Wayne, IN 46845-1707 | 2005-07-28 |
| 1528024783 | William A Loe Jr. | Surgery | 11123 Parkview Plaza Dr Ste 200, Fort Wayne, IN 46845 | 2006-04-25 |
| 1669455267 | Great Lakes Pediatric Surgeons, Inc. | Surgery | 7613 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804-4182 | 2005-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194081760 | Britney Lynne Grayson | Surgery | 8040 Clearvista Pkwy Ste 460, Indianapolis, IN 46256-4673 | 2012-04-07 |
| 1962592469 | Evan R. Kokoska | Surgery | 2001 W. 86th Street, Pediatric Hospital, Indianapolis, IN 46260 | 2006-10-13 |
| 1790880292 | Pediatric Surgical Associates Inc | Surgery | 250 N Shadeland Ave Ste 200, Indianapolis, IN 46219-4959 | 2006-09-13 |
| 1902833395 | Sunghoon Kim | Surgery | 8040 Clearvista Pkwy Ste 340, Indianapolis, IN 46256-4673 | 2006-06-28 |
| 1225464324 | Halkawt Ali Nuri | Surgery | 545 Barnhill Dr, Suite 215, Indianapolis, IN 46202-5112 | 2013-09-20 |
| 1184881641 | Jeremy Herrmann | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2008-05-21 |
| 1548317431 | Matthew Landman | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2007-01-04 |
| 1811066608 | Robert C Burns | Surgery | 705 Riley Hospital Dr, Ste 2500, Indianapolis, IN 46202-5109 | 2006-11-07 |
| 1699855304 | John W Brown | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2006-10-17 |
| 1841393311 | Mark Rodefeld | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2006-09-07 |
| Find all providers with the same taxonomy | ||||
| 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.