IMPACT PHYSICIAN GROUP, INDIANA, PULMONARY (NPI# 1083184873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083184873 |
| Entity Type | Organization |
| Organization Name | IMPACT PHYSICIAN GROUP, INDIANA, PULMONARY |
| Practice Address |
1700 W 10th St Indianapolis IN 46222-3802 |
| Mailing Address |
21 Eastbrook Bnd Ste 218 Peachtree City GA 30269-1546 |
| Practice Telephone | 3176364400 |
| Mailing Telephone | 6789675599 |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2018-12-05 |
| Authorized Official Name | MR. PAUL MILLER (OWNER/CEO) |
| Authorized Official Telephone | 6789675599 |
| Authorized Official Credential | CEO |
| Is Organization Subpart | Y |
| Parent Organization Name | IMPACT PHYSICIAN GROUP, INDIANA, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians |
| Street Address |
1700 W 10TH ST |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46222-3802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558446021 | Kindred Hospitals Limited Partnership | Long Term Care Hospital | 1700 W 10th St, Indianapolis, IN 46222-3802 | 2006-10-25 |
| 1811354715 | Janelle Owens | Physician Assistant | 1700 W 10th St, Indianapolis, IN 46222-3802 | 2016-01-22 |
| 1710216312 | Knd Development 59 LLC | Hospitalist | 1700 W 10th St, Indianapolis, IN 46222-3802 | 2009-12-10 |
| 1801044276 | Kindred Hospitals Limited Partnership | Specialist | 1700 W 10th St, Indianapolis, IN 46222-3802 | 2008-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871194472 | Megan Mccullough | Pharmacist | 10617 East Washington Street, Pharmacy At Walmart, Indianapolis, IN 46222 | 2020-11-02 |
| 1215401450 | Resilient Services | Counselor | 3519 W Michigan Street, Indianapolis, IN 46222 | 2019-01-21 |
| 1376925487 | Ossama Elbarawy | Dentist | 2410 W. 17th St, Indianapolis, IN 46222 | 2015-06-25 |
| 1780025163 | Suzy Q Service Cororation | Chore Provider | 2401 N Tibbs Ave, Indianapolis, IN 46222 | 2013-07-12 |
| 1952607939 | Monica Lee Mcmullen | Dietitian, Registered | 2732 West Michigan St., Westside Health Center, Indianapolis, IN 46222 | 2011-02-08 |
| 1306082318 | Jose Fanor Melendez | Psychiatry & Neurology | 3422 N. Taft Av, Indianapolis, IN 46222 | 2008-12-22 |
| 1861693277 | David Hazra | Preventive Medicine | 340 S. White River Parkway, Indianapolis, IN 46222 | 2007-05-31 |
| 1528191467 | Rem Indiana | Intermediate Care Facility, Mentally Retarded | 3025 Green Hills Lane, Indianapolis, IN 46222 | 2007-03-13 |
| 1366589467 | Indianapolis Osteopathic Hospital Inc. | Podiatrist | 3520 Guion Rd Suite 204, Indianapolis, IN 46222 | 2007-01-30 |
| 1508919077 | Ronald L. Gemma | Family Medicine | 3750 Guion Rd., Ste. 185, Indianapolis, IN 46222 | 2007-01-19 |
| Find all providers in zip 46222 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730422163 | Richard Evers Brashear | Internal Medicine | 7914 Beaumont Green West Dr, Indianapolis, IN 46250-1651 | 2013-04-04 |
| 1558603829 | Don Coleman Weiser | Internal Medicine | 8803 N. Meridian St Suite 250, Midwest Institute for Clinical Research, Indianapolis, IN 46260 | 2013-03-25 |
| 1093789380 | Abboud Kawak | Internal Medicine | 1550 E County Line Rd Ste 325, Indianapolis, IN 46227-0967 | 2006-02-14 |
| 1487656385 | David B Cook | Internal Medicine | 8330 Allison Pointe Trl, Indianapolis, IN 46250-1682 | 2005-08-11 |
| 1457355968 | Frederick A Tolle | Internal Medicine | 6744 Robin Hood Ct, Indianapolis, IN 46227-7314 | 2005-06-13 |
| 1881698272 | Richard H Rhodes | Internal Medicine | 9025 Admirals Pointe Dr, Indianapolis, IN 46236-9050 | 2005-06-13 |
| 1114346822 | Francesca Duncan | Internal Medicine | 1120 W Michigan St, Gatch Hall Cl 285, Indianapolis, IN 46202 | 2014-04-09 |
| 1306263439 | Marcela Augusta Azevedo | Internal Medicine | 1120 W Michigan St # Cl285, Indianapolis, IN 46202 | 2014-03-26 |
| 1346588688 | St. Vincent Health Wellness and Preventive Care Institute, Inc. | Internal Medicine | 8333 Naab Rd, Suite 301, Indianapolis, IN 46260-5924 | 2013-01-22 |
| 1649529462 | Central Indiana Pulmonary Consultants, LLC | Internal Medicine | 1350 E County Line Rd, Suite H, Indianapolis, IN 46227-0873 | 2012-09-07 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46222 |
Please comment or provide details below to improve the information on IMPACT PHYSICIAN GROUP, INDIANA, PULMONARY.
| 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.