DOUGLAS L GRAY (NPI# 1891787651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891787651 |
| Entity Type | Individual |
| Full Name | DOUGLAS L GRAY |
| Credential | MD |
| Practice Address |
11108 Parkview Circle Dr Suite 5100 Fort Wayne IN 46845-1730 |
| Mailing Address |
1234 E Dupont Rd Suite 1 Fort Wayne IN 46825-1545 |
| Practice Telephone | 2602662800 |
| Practice Fax Number | 2602662805 |
| Mailing Telephone | 2603739700 |
| Mailing Fax Number | 2603739740 |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2013-03-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 01044841A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | RAILROAD MEDICARE | 060048219 | 01 |
| IN | ANTHEM | 000000595620 | 01 |
| IN | 200178590 | 05 | |
| IN | RAILROAD MEDICARE | P00664358 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649288796 | Douglas J. Gray | Dentist | 435 York Street, York Harbor, ME 03911-1108 | 2006-08-04 |
| 1285631317 | Douglas Theodore Gray | Social Worker | 211 Parsons Ave, Yakima, WA 98908-1734 | 2005-07-05 |
| 1003463035 | Douglas Gray | Case Manager/Care Coordinator | 7695 Poe Ave, Dayton, OH 45414-2552 | 2019-08-23 |
| 1114313491 | Douglas Scott Gray | Registered Nurse | 109 Bee St, Charleston, SC 29401-5703 | 2015-04-13 |
| 1154429223 | Douglas D Gray | Psychiatry & Neurology | 650 Komas Dr, #208, Salt Lake City, UT 84108-1215 | 2006-09-20 |
| 1144244336 | Douglas L Gray | Ophthalmology | 602 W. University Avenue, Ophthalmology / Optometry, Urbana, IL 61801 | 2006-07-27 |
| 1942242946 | Douglas W Gray | Dentist | 230 Temple St, Mason, MI 48854-1837 | 2006-06-12 |
| 1851367825 | Douglas R Gray | Optometrist | Madigan Army Medical Ctr, 9040 Jackson Ave, Tacoma, WA 98431-1100 | 2006-02-28 |
| Street Address |
11108 PARKVIEW CIRCLE DR SUITE 5100 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-1730 |
| 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 |
| 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 | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114122488 | Hannah Copeland | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 7910 W Jefferson Blvd Ste 102, Fort Wayne, IN 46804-4159 | 2007-06-18 |
| 1356544308 | Melmar LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2410 N Glendale Dr, Suite C, Fort Wayne, IN 46804-8908 | 2007-06-07 |
| 1578655494 | Marcus A Jimenez | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2510 N Glendale Drive, Suite C, Fort Wayne, IN 46804 | 2006-09-28 |
| 1639171499 | John R Stanford | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2414 E State Blvd, Carew Building #1, Suite 201, Fort Wayne, IN 46805-4760 | 2005-08-11 |
| 1154616175 | Tariq Omar Lescouflair | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11108 Parkview Circle Dr Ste 5100, Fort Wayne, IN 46845 | 2011-06-17 |
| 1699975342 | Christopher J. Gullett | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 7910 W Jefferson Blvd Ste 102, Fort Wayne, IN 46804-4159 | 2007-07-20 |
| 1205989159 | Fort Wayne Cardiovascular Associates | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11123 Parkview Plaza Dr, Suite 202, Fort Wayne, IN 46845-1707 | 2007-01-22 |
| 1215080692 | Fort Wayne Cardiovascular Associates | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 800 Broadway, Suite 201, Fort Wayne, IN 46802-2149 | 2007-01-19 |
| 1790718765 | Fort Wayne Cardiovascular Surgeon | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11123 Parkview Plaza Dr, Suite 202, Fort Wayne, IN 46845-1707 | 2006-07-10 |
| 1679551741 | Fort Wayne Cardiovascular Surgeons, PC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1818 Carew St, Suite 250, Fort Wayne, IN 46805-4788 | 2006-01-09 |
| 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.