NEIL WANGSTROM MD PC (NPI# 1043307978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1043307978 |
Entity Type | Organization |
Organization Name | NEIL WANGSTROM MD PC |
Other Organization Name | NORTHWEST INDIANA ENT ASSOICATES |
Practice Address |
304 Detroit St La Porte IN 46350-2473 |
Practice Telephone | 2193253770 |
Practice Fax Number | 2193258181 |
Mailing Telephone | 2193253770 |
Mailing Fax Number | 2193258181 |
Enumeration Date | 2006-10-10 |
Last Update Date | 2009-09-29 |
Authorized Official Name | MRS. ROBIN M HENRICH (PRACTICE MANAGER) |
Authorized Official Telephone | 2193253770 |
Authorized Official Credential | CMPC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 231H00000X | Audiologist | 23002292A | IN | Speech, Language and Hearing Service Providers |
N | 363L00000X | Nurse Practitioner | 71001701A | IN | Physician Assistants & Advanced Practice Nursing Providers |
N | 363L00000X | Nurse Practitioner | 71001740A | IN | Physician Assistants & Advanced Practice Nursing Providers |
Y | 207Y00000X | Otolaryngology | 01038858 | IN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 100165330A | 05 | |
IN | ANTHEM | 000000105404 | 01 |
IN | 200245050A | 05 | |
IN | 100165330 | 05 | |
IN | 200482190 | 05 |
Other Name | Type Code |
---|---|
Northwest Indiana ENT Assoicates | Former Legal Business Name - Organization |
Street Address |
304 DETROIT ST |
City | LA PORTE |
State | IN |
Zip Code | 46350-2473 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730189820 | Neil William Wangstrom | Otolaryngology | 304 Detroit St, La Porte, IN 46350-2497 | 2005-07-29 |
1346707841 | Mackenzie Jacquelyn Blust | Physician Assistant | 304 Detroit St, La Porte, IN 46350-2497 | 2019-02-21 |
1972776292 | Jessica L Nichols | Audiologist | 304 Detroit St, La Porte, IN 46350-2497 | 2008-04-08 |
1750456356 | Jerry A Montgomery | Social Worker | 304 Detroit St, Suite A, La Porte, IN 46350-2473 | 2006-11-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871139246 | Carolyn Ann Perra | Pharmacist | 55 Pine Lake S.c., Laporte, IN 46350 | 2019-11-20 |
1306496492 | Trinity Healthcare Inc. | Occupational Therapist | 2002 Andrew Avenue, Laporte, IN 46350 | 2019-09-19 |
1184136665 | Diane Margaret Rich | Physical Therapist | 1643 S Willow Bend Dr, La Porte, IN 46350 | 2017-10-24 |
1114460102 | Judith Marie Fitzhugh | Dietitian, Registered | 1775 S. Basswood Trail, Laporte, IN 46350 | 2016-11-23 |
1568916971 | Total Renal Care, Inc. | Clinic/Center | 1406 E Lincolnway, Ste A, La Porte, IN 46350 | 2016-08-15 |
1083079008 | Irene Torres | Nurse Practitioner | 1407 Lincolnway, La Porte, IN 46350 | 2015-12-17 |
1124422910 | Becky Alwood-wallace | Occupational Therapist | 1203 Washington Street, Iu Health La Porte Hospital Wellness & Rehabilitation, La Porte, IN 46350 | 2014-10-22 |
1881001527 | Johnson Memorial Hospital | Skilled Nursing Facility | 3530 Monroe Street, La Porte, IN 46350 | 2014-07-15 |
1306268941 | Tiffany Anne Satterfield | Physical Therapy Assistant | 194 S 400 E, Laporte, IN 46350 | 2014-01-16 |
1801122239 | Mary Barbara Backer | Internal Medicine | 301 Willow Bend Dr, La Porte, IN 46350 | 2009-10-20 |
Find all providers in zip 46350 |
Taxonomy Code | 207Y00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
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 Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730189820 | Neil William Wangstrom | Otolaryngology | 304 Detroit St, La Porte, IN 46350-2497 | 2005-07-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477182988 | Allergy and Audiology Services of Northwest Indiana LLC | Otolaryngology | 900 Ridge Rd Ste E, Munster, IN 46321-1727 | 2020-04-06 |
1881221208 | Morgan Sandelski | Otolaryngology | 2015 Central Ave, Indianapolis, IN 46202-1634 | 2020-03-25 |
1922562339 | Transcend Anesthesia, PC | Otolaryngology | 1655 N Gladstone Ave Ste E, Columbus, IN 47201-5380 | 2019-01-30 |
1023523610 | Family Ent Specialists, LLC | Otolaryngology | 3200 Sycamore Ct Ste 1d, Columbus, IN 47203-1545 | 2017-12-05 |
1699295956 | David Joseph Trout | Otolaryngology | 816 Lazy Ln, Lafayette, IN 47904-2722 | 2017-06-27 |
1437687126 | Dhruv Sharma | Otolaryngology | 1130 W Michigan St # Fh400, Indianapolis, IN 46202-5209 | 2017-05-25 |
1235585878 | Alhasan Najib Elghouche | Otolaryngology | 12860 University Cres, Apt 1a, Carmel, IN 46032-9472 | 2016-05-13 |
1093133415 | Bruce Jordan Hopkins | Otolaryngology | 1569 Preston Trl, Carmel, IN 46032-8970 | 2014-04-02 |
1861813776 | Rachael L Raffle | Otolaryngology | 1429 N 6th St Fl 3, Terre Haute, IN 47807-1019 | 2013-12-18 |
1043658818 | Jessica A. Yesensky | Otolaryngology | 1544 Carrollton Ave, Indianapolis, IN 46202-2717 | 2013-06-13 |
Find all providers with the same taxonomy |
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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.