KOKOMO ACADEMY (NPI# 1043496060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043496060 |
| Entity Type | Organization |
| Organization Name | KOKOMO ACADEMY |
| Practice Address |
623 S Berkley Rd Kokomo IN 46901-5150 |
| Mailing Address |
900 Keystone Crossing Ste 1040 Indianapolis IN 46240 |
| Practice Telephone | 7654529989 |
| Mailing Telephone | 3176944074 |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-01-22 |
| Authorized Official Name | ROGER SNYDER (VICE PRESIDENT) |
| Authorized Official Telephone | 3172741359 |
| Authorized Official Credential | CFO |
| Is Organization Subpart | Y |
| Parent Organization Name | CORRECTIONAL MANAGEMENT COMPANY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
IN | Behavioral Health & Social Service Providers |
| Street Address |
623 S BERKLEY RD |
| City | KOKOMO |
| State | IN |
| Zip Code | 46901-5150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607597 | Momentum Kokomo, LLC | Substance Abuse Rehabilitation Facility | 1236 N. Wabash Ave, Kokomo, IN 46901 | 2020-10-23 |
| 1457826869 | Jodi Gayle Lake | Developmental Therapist | 2523 Lorentson Ct, Kokomo, IN 46901 | 2018-10-11 |
| 1871088369 | Hope Behavioral Servies, LLC | Behavioral Analyst | 924 Clark St, Kokomo, IN 46901 | 2018-06-27 |
| 1255782306 | Forefront Dermatology, S.c. | Dermatology | 2130 W Sycamore St Ste 200, Kokomo, IN 46901 | 2016-06-29 |
| 1164860706 | Renee Michelle Brown | Registered Nurse | 2776 Amberwood Place, Kokomo, IN 46901 | 2013-06-05 |
| 1063642916 | Michelle K Rush | Speech-Language Pathologist | 2532 Lauren Ln, Kokomo, IN 46901 | 2009-07-24 |
| 1396957189 | Lifetime Dental Care of In, PC | Dentist | 927 S Washington St, Kokomo, IN 46901 | 2007-05-04 |
| 1245458355 | Wagoner Medical Center, LLC | Internal Medicine | 2016 W Sycamore, Kokomo, IN 46901 | 2007-04-23 |
| 1053442723 | Jesusa Salhieh | Contractor | Genesis Rehab Bloom, Kokomo, IN 46901 | 2007-03-07 |
| 1740382928 | Donald A Fantuzzo Dds PC | Dentist | 2196 W Sycamore St, Kokomo, IN 46901 | 2006-09-01 |
| Find all providers in zip 46901 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417505538 | John Pierre Rudy | Psychologist | 3464 Cinnamon Trce, Kokomo, IN 46901-3981 | 2019-09-02 |
| 1538170188 | Scott Andrew Edwards | Psychologist | 1216 W Jefferson St, Kokomo, IN 46901-4341 | 2006-08-10 |
| 1265869804 | Judey M Anders | Psychologist | 1531 Rockford Ct, Kokomo, IN 46902-3207 | 2013-09-27 |
| 1154762664 | Aimee Dershowitz | Psychologist | 1948 W Boulevard, Kokomo, IN 46902-6078 | 2013-07-12 |
| 1922042647 | Paul Joseph Roberts | Psychologist | 1907 W Sycamore St, Kokomo, IN 46901-4113 | 2006-06-15 |
| 1245271907 | Patrick Mario Webb | Psychologist | 1907 W Sycamore St, Kokomo, IN 46901-5148 | 2006-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770196842 | Ariel C Breaux | Psychologist | 800 Bus Stop Dr, Madison, IN 47250 | 2020-08-28 |
| 1841816048 | Christina E Maxwell Phd | Psychologist | 6337 Hollister Driive, Suite 101, Indianapolis, IN 46224-2996 | 2020-06-23 |
| 1154942340 | Craig Allan Nordstrom | Psychologist | 111 E Clearwater Ave, Beverly Shores, IN 46301-0056 | 2020-04-29 |
| 1164052791 | Kadlec Consulting Services, LLC | Psychologist | 5525 Oak Valley Pl, Fort Wayne, IN 46845-1836 | 2020-01-23 |
| 1568001469 | Monica Anne Cotter | Psychologist | Adam Benjamin Jr. Va Outpatient Clinic, 9301 Madison, Crown Point, IN 46307-4630 | 2019-12-26 |
| 1265995500 | Jamie Garvey | Psychologist | Saint Liam Hall, 220 Main Buildig, Notre Dame, IN 46556 | 2019-04-12 |
| 1902362619 | Geoffrey Edwards Buck | Psychologist | 9245 N Meridian St # 111, Indianapolis, IN 46260-1836 | 2019-02-18 |
| 1447722483 | Steven James Eckert | Psychologist | 4700 Bureau Rd N, Terre Haute, IN 47802-8246 | 2018-12-31 |
| 1215403167 | Sean Kristen Jones | Psychologist | 11725 N Illinois St Ste 355, Carmel, IN 46032-3009 | 2018-10-18 |
| 1053894501 | Thrive Psychology Services, LLC | Psychologist | 4120 W Dresden Dr, Bloomington, IN 47404-8403 | 2018-09-11 |
| 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.