AXON HEALTH ASSOCIATES, LLC (NPI# 1033552310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033552310 |
| Entity Type | Organization |
| Organization Name | AXON HEALTH ASSOCIATES, LLC |
| Practice Address |
10585 N Meridian St Suite 201 Indianapolis IN 46290-1069 |
| Practice Telephone | 3178189000 |
| Practice Fax Number | 3178189009 |
| Mailing Telephone | 3178189000 |
| Mailing Fax Number | 3178189009 |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2013-04-16 |
| Authorized Official Name | JERAD DALTON (OWNER) |
| Authorized Official Telephone | 3178189000 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
IN | Allopathic & Osteopathic Physicians |
| Street Address |
10585 N MERIDIAN ST SUITE 201 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46290-1069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497808703 | Teresa D. Erickson | Physical Therapist | 10585 N Meridian St, Suite 201, Indianapolis, IN 46290-1069 | 2007-01-19 |
| 1487821856 | Serdan Group, LLC | Clinic/Center | 10585 N Meridian St, Suite 340, Indianapolis, IN 46290-1069 | 2008-05-14 |
| 1346453941 | Ana Velia Cofresi | Psychologist | 10585 N Meridian St, Suite 340, Indianapolis, IN 46290-1069 | 2007-05-08 |
| 1609996388 | Choices Psychology Consultation Center, Inc. | Psychologist | 10585 N Meridian St, Suite 340, Indianapolis, IN 46290-1069 | 2007-03-29 |
| 1043352149 | Finlay Grier | Psychologist | 10585 N Meridian St, Suite 340, Indianapolis, IN 46290-1069 | 2007-02-13 |
| 1740320977 | Philip Meredith Coons | Psychiatry & Neurology | 10585 N Meridian St, Suite 340, Indianapolis, IN 46290-1069 | 2007-02-07 |
| 1235276692 | Sarah Hermann Russell | Psychologist | 10585 N Meridian St, Suite 340, Indianapolis, IN 46290-1069 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821548777 | American Behavioral Counseling | Social Worker | 10386 Spring Highland Dr, Indianapolis, IN 46290 | 2016-10-04 |
| 1518042431 | James Lamar Jones | Psychologist | 8555 Cedar Place, Suite 113a, Indianapolis, IN 46290 | 2006-10-26 |
| 1437245917 | Bradley Scott Gunter | Physical Therapy Assistant | 10601 N. Meridian St., Suite 110, Indianapolis, IN 46290 | 2006-10-04 |
| 1790261576 | Kristiana Michelle Sannella | Physician Assistant | 10590 N Meridian St # 105, Indianapolis, IN 46290 | 2018-07-16 |
| 1023534815 | Mitchell James Vansumeren | Psychologist | 10291 N Meridian St Ste 310, Indianapolis, IN 46290 | 2017-08-14 |
| 1801281670 | Elizabeth Tibbs | Physician Assistant | 10590 N Meridian St Ste 105, Indianapolis, IN 46290 | 2015-03-30 |
| 1447510722 | Bradley A Clark | Internal Medicine | 10590 N Meridian St, Indianapolis, IN 46290 | 2012-05-21 |
| 1528333861 | Edward Mark Shmukler | Internal Medicine | 10590 N Meridian St, Indianapolis, IN 46290 | 2012-03-20 |
| 1386938272 | Bryce S Lynn | Internal Medicine | 10590 N Meridian St, Indianapolis, IN 46290 | 2011-06-08 |
| 1063610301 | Babar Sultan | Otolaryngology | 170 W 106th St, Meridian Plastic Surgery, Indianapolis, IN 46290 | 2007-07-09 |
| Find all providers in zip 46290 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821060294 | Michael Welling | Psychiatry & Neurology | 2040 Shadeland Ave, Ste 200, Indianapolis, IN 46219-1734 | 2006-02-01 |
| 1184616294 | Fadia T Aldahan | Psychiatry & Neurology | 5502 East 16th Street, Suite A21, Indianapolis, IN 46218-4932 | 2005-08-16 |
| 1700337920 | Kledzik Psychiatric LLC | Psychiatry & Neurology | 9245 N Meridian St, 225, Indianapolis, IN 46260-1836 | 2016-10-24 |
| 1225477409 | Huma M Hosain | Psychiatry & Neurology | 355 W 16th St, #2364, Indianapolis, IN 46202-2207 | 2013-06-20 |
| 1235422429 | Genalynne Carwile Mooneyham | Psychiatry & Neurology | 1111 W 10th St, #201, Indianapolis, IN 46202-4800 | 2011-05-19 |
| 1396924742 | Correctional Management Company | Psychiatry & Neurology | 9000 Keystone Xing, Suite 1040, Indianapolis, IN 46240-2118 | 2007-11-01 |
| 1790989671 | Ann M Kledzik | Psychiatry & Neurology | 702 Barnhill Dr, #4300, Indianapolis, IN 46202-5128 | 2007-06-13 |
| 1740401421 | Melisa Ybarra Martinez | Psychiatry & Neurology | 1500 N Ritter Ave, Indianapolis, IN 46219-3027 | 2007-05-01 |
| 1194819714 | Robert Peter Mohlman | Psychiatry & Neurology | 320 North Tibbs Avenue, Indianapolis, IN 46222 | 2006-10-03 |
| 1598869786 | Susanne Blix | Psychiatry & Neurology | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2006-09-11 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46290 |
Please comment or provide details below to improve the information on AXON HEALTH ASSOCIATES, LLC.
| 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.