TRAVIS HALDEMAN (NPI# 1033162425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033162425 |
| Entity Type | Individual |
| Full Name | TRAVIS HALDEMAN |
| Credential | D.O. |
| Practice Address |
3545 Arbor Blvd Portage IN 46368-4298 |
| Mailing Address |
1500 S Lake Park Ave Hobart IN 46342-6638 |
| Practice Telephone | 7086369205 |
| Practice Fax Number | 7082296075 |
| Mailing Telephone | 2199476153 |
| Mailing Fax Number | 2197036501 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2018-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 02004689A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201321810 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1500 S Lake Park Ave Ste 205, Hobart, IN 463426638 | 2199428620 | 2199426356 |
| Street Address |
3545 ARBOR BLVD |
| City | PORTAGE |
| State | IN |
| Zip Code | 46368-4298 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861852758 | Meghan Goranson | Physical Therapy Assistant | 3545 Arbor Blvd, Portage, IN 46368-4298 | 2016-03-04 |
| 1104157064 | Portage Health Center Occupational Health | Clinic/Center | 3545 Arbor Blvd, Portage, IN 46368-4297 | 2010-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1831576693 | Bishara Robert Khoury | Family Medicine | 3545 Arbor Blvd Ste E, Portage, IN 46368 | 2015-04-30 |
| 1962813535 | Diane Farrington | Pharmacist | 6050 Us Hwy 6, Portage, IN 46368 | 2014-05-16 |
| 1588827562 | Jennifer Ann Rumpel | Allergy & Immunology | 6375 Us Highway 6 Ste C, Portage, IN 46368 | 2008-07-09 |
| 1588822688 | Total Renal Care Inc | Clinic/Center | 5823 Us Highway 6, Portage, IN 46368 | 2008-05-27 |
| 1235321480 | Michael Wendahl | Physical Therapist | 3691 Willowcreek Road, Suite 100, Portage, IN 46368 | 2007-08-13 |
| 1679663603 | Stephen V Headley | Family Medicine | 3283 Willowcreek Rd, Portage, IN 46368 | 2006-10-13 |
| 1730276486 | Robert Tan Ang | Psychiatry & Neurology | 3156 Willowcreek Road, Portage, IN 46368 | 2006-10-06 |
| 1013029883 | Primary Care PC | Family Medicine | 3125 Willowcreek Road, Portage, IN 46368 | 2006-08-31 |
| 1104936962 | Margaret Eileen Griffith | Dentist | 2646 Lois Street, Portage, IN 46368 | 2006-08-30 |
| Find all providers in zip 46368 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992870398 | The Woman's Wellness Center, P.C. | Obstetrics & Gynecology | 3630 Willowcreek Road, Suite 10, Portage, IN 46368-5075 | 2006-11-21 |
| 1801852165 | Daniel Lawrence Lott | Obstetrics & Gynecology | 3564 Scottsdale St, Portage, IN 46368-5420 | 2006-04-25 |
| 1649250242 | Scott M Peterson | Obstetrics & Gynecology | 3300 W Centre Ave, Bronson Ob Gyn Associates, Portage, MI 49024-4666 | 2006-01-19 |
| 1083976682 | Sara Lynn Deatsman | Obstetrics & Gynecology | 3300 W Centre Ave, Portage, MI 49024-4666 | 2012-06-11 |
| 1538459813 | Amber Rachelle Nash-guilford | Obstetrics & Gynecology | 7895 Currier Dr, Portage, MI 49002-4314 | 2011-04-08 |
| 1083925333 | St Mary Medical Center Inc | Obstetrics & Gynecology | 3545 Arbors Street, Portage, IN 46368-4297 | 2010-07-01 |
| 1689841165 | Women's Medical Care LLC | Obstetrics & Gynecology | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2008-05-13 |
| 1285856245 | Jessica Lynn Puckett | Obstetrics & Gynecology | 3300 W Centre Ave, Portage, MI 49024-4666 | 2007-05-02 |
| 1952453474 | Jennifer Margaret Carman | Obstetrics & Gynecology | 3300 W Centre Ave, Portage, MI 49024-4666 | 2007-01-17 |
| 1104922483 | Miljan R Stankovic | Obstetrics & Gynecology | 3564 Scottsdale St, Portage, IN 46368-5420 | 2006-09-15 |
| Find all providers in PORTAGE | ||||
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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.