DR. SHIVA GAUCHAN (NPI# 1275811457) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275811457 |
| Entity Type | Individual |
| Full Name | DR. SHIVA GAUCHAN |
| Credential | M.D. |
| Practice Address |
11109 Parkview Plaza Dr. Fort Wayne IN 46845-1701 |
| Mailing Address |
1234 E. Dupont Rd. Ste 1 Fort Wayne IN 46825-1701 |
| Practice Telephone | 2602662020 |
| Practice Fax Number | 2602662009 |
| Mailing Telephone | 2603739700 |
| Mailing Fax Number | 2603739740 |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2013-03-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 01070823A | IN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 036128601 | IL | Student, Health Care |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 125055779 | IL | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM | 000000766040 | 01 |
| Street Address |
11109 PARKVIEW PLAZA DR. |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-1701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962494971 | Roger Scott Stienecker | Internal Medicine | 11109 Parkview Plaza Dr., Fort Wayne, IN 46845-1701 | 2005-08-16 |
| 1861980211 | Jesse Christman | Pharmacist | 11109 Parkview Plaza Dr., Inpatient Pharmacy, Fort Wayne, IN 46845 | 2018-05-01 |
| 1871002659 | Samuel Martinez | Dietitian, Registered | 11109 Parkview Plaza Dr., Fort Wayne, IN 46846 | 2017-09-25 |
| 1568695054 | Reena Thapa | Internal Medicine | 11109 Parkview Plaza Dr., Fort Wayne, IN 46845-1701 | 2009-08-31 |
| 1205089414 | Maria Ferling Curfman | Internal Medicine | 11109 Parkview Plaza Dr., Fort Wayne, IN 46845-1701 | 2008-10-31 |
| 1992954986 | Natosha E. Minick | Registered Nurse | 11109 Parkview Plaza Dr., Fort Wayne, IN 46845-1701 | 2008-09-15 |
| 1306000351 | Jitendra Sah | Internal Medicine | 11109 Parkview Plaza Dr., Fort Wayne, IN 46845-1707 | 2008-07-17 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1053709402 | Sheila Falloon Md LLC | Internal Medicine | 6232 Shady Creek Ct, Fort Wayne, IN 46814-3298 | 2015-01-07 |
| 1043644354 | Fort Wayne Medical Clinic PC | Internal Medicine | 3537 N Anthony Blvd Ste C, Fort Wayne, IN 46805-1423 | 2013-08-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1215377296 | Ram Kishun Verma | Internal Medicine | 1234 E Dupont Rd Ste 5, Fort Wayne, IN 46825 | 2013-07-05 |
| 1871840934 | Amabel Pia A Lapuebla | Internal Medicine | 11104 Parkview Circle Dr Ste 440, Fort Wayne, IN 46845-1672 | 2012-08-08 |
| 1538432141 | C & D Healthcare Services, LLC | Internal Medicine | 327 E Wayne St, Fort Wayne, IN 46802-2753 | 2012-02-13 |
| 1407141500 | Patrick Joseph Wise | Internal Medicine | 6435 W Jefferson Blvd, Fort Wayne, IN 46804-6203 | 2011-06-16 |
| 1235438185 | Blue Crescent Blue Star Medical of Indiana, Inc | Internal Medicine | 2326 Hobson Rd, Fort Wayne, IN 46805-2916 | 2011-03-17 |
| 1336441948 | Vishaal Veerula | Internal Medicine | 7802 W. Jefferson Blvd. #b, Fort Wayne, IN 46804 | 2010-12-02 |
| 1609019900 | Srisai P C | Internal Medicine | 7972 West Jefferson Blvd, Suite A, Fort Wayne, IN 46804-4140 | 2009-04-16 |
| 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.