FORT WAYNE CARDIOVASCULAR SURGEON
NPI 1790718765
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Fort Wayne, IN

Q: What is Fort Wayne Cardiovascular Surgeon's NPI number?

The NPI number for Fort Wayne Cardiovascular Surgeon is 1790718765. It was assigned to this organization in the NPPES registry on July 10, 2006.

Q: What is Fort Wayne Cardiovascular Surgeon's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Active since July 10, 2006

11123 PARKVIEW PLAZA DR, SUITE 202, FORT WAYNE, IN 46845(260) 483-6448(260) 373-4167 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Fort Wayne Cardiovascular Surgeon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FORT WAYNE CARDIOVASCULAR SURGEON (NPI 1790718765) is a healthcare organization registered as a thoracic surgery (cardiothoracic vascular surgery) in Fort Wayne, Indiana and active in the NPI registry since July 2006. The organization lists Douglas L Gray, President/partner, as its authorized official.

NPPES Registry Identity

NPI1790718765

Entity TypeOrganization

Primary Taxonomy208G00000X

Legal Business NameFORT WAYNE CARDIOVASCULAR SURGEON

Location Address11123 PARKVIEW PLAZA DR, SUITE 202Fort Wayne, IN 46845-1707

Mailing Address1818 Carew Streeet, Suite 250Fort Wayne, IN 46805 · (260) 483-6448 · Fax (260) 373-4167

Phone(260) 483-6448

Fax(260) 373-4167

Organization SubpartNo

Authorized OfficialDouglas L GrayPresident/partner · (260) 483-6448

Enumeration DateJuly 10, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1790718765 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians

Taxonomy Code208G00000X

License✔ Licensed in IN · 50000046A

Definition

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.

11123 PARKVIEW PLAZA DR, Fort Wayne, IN 46845

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARA E WALKER APN

Nurse Practitioner (Women's Health)

11123 PARKVIEW PLAZA DR, SUITE 101
FORT WAYNE, IN 46845

Allen County (260) 422-7455

AMANDA RINGWOOD

Nurse Practitioner

11123 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845

Allen County (260) 373-5830

STARR NEWMAN P.A.

Physician Assistant

11123 PARKVIEW PLAZA DR, # 102
FORT WAYNE, IN 46845

Allen County (260) 483-0688

WIELAND & ASSOCIATES, INC.

Psychologist

11123 PARKVIEW PLAZA DR, SUITE 200
FORT WAYNE, IN 46845

Allen County (260) 672-6510

KELSEA KAY LEROSE NP

Nurse Practitioner

11123 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845

Allen County (260) 425-6650

FORT WAYNE CARDIOVASCULAR ASSOCIATES

Thoracic Surgery (Cardiothoracic Vascular Surgery)

11123 PARKVIEW PLAZA DR, SUITE 202
FORT WAYNE, IN 46845

Allen County (260) 483-6448

JOHN E DRAKE D.O.

Obstetrics & Gynecology

11123 PARKVIEW PLAZA DR, SUITE 101
FORT WAYNE, IN 46845

Allen County (260) 422-7455

MRS. NANCY SUE HINTON NP

Nurse Practitioner (Adult Health)

11123 PARKVIEW PLAZA DR, SUITE 206
FORT WAYNE, IN 46845

Allen County (260) 266-2020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fort Wayne Cardiovascular Surgeon's NPI number?

The NPI number for Fort Wayne Cardiovascular Surgeon is 1790718765. It was assigned to this organization in the NPPES registry on July 10, 2006.

Where is Fort Wayne Cardiovascular Surgeon located?

Fort Wayne Cardiovascular Surgeon is located at 11123 Parkview Plaza Dr Suite 202, Fort Wayne, IN 46845. The listed phone number is (260) 483-6448.

What is Fort Wayne Cardiovascular Surgeon's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

When was this NPI record last updated?

The NPPES record for Fort Wayne Cardiovascular Surgeon was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.