HOLLACE D CHASTAIN (NPI# 1013919422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013919422 |
| Entity Type | Individual |
| Full Name | HOLLACE D CHASTAIN |
| Credential | MD |
| Practice Address |
11108 Parkview Circle Dr Fort Wayne IN 46845-1730 |
| Mailing Address |
1234 E Dupont Rd Suite 3 Fort Wayne IN 46825-1545 |
| Practice Telephone | 2602665700 |
| Practice Fax Number | 2602665920 |
| Mailing Telephone | 2603739728 |
| Mailing Fax Number | 2604585664 |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2015-01-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
01039775A | IN | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
01039775A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM | 000000641068 | 01 |
| IN | 200322020 | 05 | |
| OH | 2232319 | 05 | |
| IN | R.R. MEDICARE | P00786816 | 01 |
| IN | RR MEDICARE | 060070569 | 01 |
| Street Address |
11108 PARKVIEW CIRCLE DR |
| 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 | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093945651 | Muzammil Hanif Musani | Internal Medicine | 7916 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2009-07-16 |
| 1093977639 | Muzammil Mushtaq | Internal Medicine | 7916 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2008-06-25 |
| 1457408320 | Matthew L Bilodeau | Internal Medicine | 7916 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710485594 | Optimal Health Network of Indiana LLC | Internal Medicine | 120 E Market St Ste 1271, Indianapolis, IN 46204-3250 | 2018-01-26 |
| 1205275948 | Benjamin Thomas Maatman | Internal Medicine | 8075 N Shadeland Ave Ste 500, Indianapolis, IN 46250-2693 | 2013-06-16 |
| 1730389586 | Akhtar Parvaiz Md | Internal Medicine | 1951 W 45th Ave, Griffith, IN 46319-3703 | 2007-07-20 |
| 1225058787 | William E Lehmkuhler, M.d. P.C. | Internal Medicine | 950 Memorial Dr, Jasper, IN 47546-2625 | 2006-07-20 |
| 1326073586 | Srinivasarao Manchikalapudi | Internal Medicine | 2109 Green Valley Rd, New Albany, IN 47150 | 2006-07-12 |
| 1548233158 | Kingsley Annan | Internal Medicine | 1928 S Dixon Rd, Kokomo, IN 46902-7302 | 2006-02-13 |
| 1194724377 | Eric F Schulte | Internal Medicine | 7863 Broadway, Suite 140, Merrillville, IN 46410-5553 | 2005-07-19 |
| 1386283281 | Seyal Cardiology LLC | Internal Medicine | 1455 Cedar St Ste D, Clarksville, IN 47129-7700 | 2019-12-26 |
| 1710440839 | 1st Choice Cardiovascular Associates LLC | Internal Medicine | 701 Superior Ave Ste J, Munster, IN 46321-4038 | 2019-04-08 |
| 1972065415 | Cind Care of In II, LLC | Internal Medicine | 120 E Market St Ste 1271, Indianapolis, IN 46204-3250 | 2019-04-03 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
Please comment or provide details below to improve the information on HOLLACE D CHASTAIN.
| 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.