DR. LARISA I ALLAKHVERDOVA (NPI# 1144219023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144219023 |
| Entity Type | Individual |
| Full Name | DR. LARISA I ALLAKHVERDOVA |
| Credential | MD |
| Practice Address |
1225 E Coolspring Ave Michigan City IN 46360-6312 |
| Mailing Address |
200 Corporate Blvd Lafayette LA 70508-3870 |
| Practice Telephone | 2198732919 |
| Mailing Telephone | 8008939698 |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2018-03-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 228819 | NY | Allopathic & Osteopathic Physicians |
| Y | 207P00000X | Emergency Medicine | 01057834A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200805060 | 05 | |
| KY | MEDICARE RAILROAD | P01186413 | 01 |
| NY | 02844177 | 05 | |
| IN | MEDICARE | M47140293 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Kings Daughters Dr, Phoenix Emergency Services of Madison, Madison, IN 472503300 | 8122655211 |
| Street Address |
1225 E COOLSPRING AVE |
| City | MICHIGAN CITY |
| State | IN |
| Zip Code | 46360-6312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508864497 | Stacey Colleen Leva | Family Medicine | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2005-07-13 |
| 1073125076 | Lakeshore Eye Consultants, LLC | Ophthalmology | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2020-08-20 |
| 1518423250 | Molly Majot | Dietitian, Registered | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2019-02-19 |
| 1427556232 | Nikole Pennington | Nurse Practitioner | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2018-01-26 |
| 1174048813 | Anna R Salyer | Occupational Therapist | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2017-08-03 |
| 1538608765 | Emily Walters | Dietitian, Registered | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2017-02-21 |
| 1184172140 | Rita Anne Halac | Nurse Practitioner | 1225 E Coolspring Ave, 2c, Michigan City, IN 46360-6312 | 2016-09-19 |
| 1609233212 | Franciscan Physician Network | Clinic/Center | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2016-01-27 |
| 1528453875 | Jennifer O'dor | Nurse Practitioner | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2015-04-03 |
| 1992101422 | Lauren Ashleigh Geers | Occupational Therapist | 1225 E Coolspring Ave, Michigan City, IN 46360-6312 | 2014-11-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821649096 | Trinity Healthcare Inc. | Occupational Therapist | 4300 Cleveland Ave, Michigan City, IN 46360 | 2019-09-27 |
| 1861905499 | Erika Leigh Maroon | Chiropractor | 8690 West Pahs Rd., Michigan City, IN 46360 | 2017-11-06 |
| 1750740650 | Michelle Asbell | Nurse Practitioner | 301 Homer St, Michigan City, IN 46360 | 2016-02-19 |
| 1235523952 | Marnee Flinn-smith | Specialist/Technologist | 8466 Pahs Rd, Michigan City, IN 46360 | 2015-03-19 |
| 1184976359 | Kelly Stewart | Physical Therapist | 301 Homer Street, Michigan City, IN 46360 | 2012-10-11 |
| 1053660936 | Planned Parenthood of Indiana Michigan City | Clinic/Center | 324 Dunes Plaza, Michigan City, IN 46360 | 2012-09-06 |
| 1114288644 | June R. R. Nichols Ocularist, Ltd | Durable Medical Equipment & Medical Supplies | 450 St. John Road, Suite 396, Michigan City, IN 46360 | 2012-05-31 |
| 1083980858 | Enoch Kassa | Internal Medicine | 3777 N Frontage Rd, Michigan City, IN 46360 | 2012-03-27 |
| 1760768196 | American Limb & Orthopedic Company of Valparaiso | Prosthetic/Orthotic Supplier | 3777 N. Frontage Rd, Suite 100, Michigan City, IN 46360 | 2011-10-31 |
| 1801181144 | Elizabeth A Whitaker | Counselor | 8733 W. 400 N., 400 North Medical Center, Michigan City, IN 46360 | 2011-06-15 |
| Find all providers in zip 46360 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104299593 | David Maldonado | Emergency Medicine | 1225 E Coolspring Ave Ste 2d, Michigan City, IN 46360 | 2015-11-05 |
| 1033527874 | Michael Owolabi | Emergency Medicine | 4111 Franklin St, Michigan City, IN 46360 | 2014-07-24 |
| 1417244484 | June Barco Brown | Emergency Medicine | 301 W Homer St, Michigan City, IN 46360-4358 | 2011-06-28 |
| 1689982621 | Noelle Hurks | Emergency Medicine | 3500 Franciscan Way, Michigan City, IN 46360-0021 | 2010-09-23 |
| 1871643791 | Patricia Gardner | Emergency Medicine | 301 W Homer St, Michigan City, IN 46360-4358 | 2007-01-11 |
| 1619076619 | Ibrahim N Mansour | Emergency Medicine | 601 W Kieffer Rd, Michigan City, IN 46360-9599 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396358255 | Vyvian Charlene Lawrence | Emergency Medicine | 5939 W Lincoln Hwy, Crown Point, IN 46307-9604 | 2020-08-28 |
| 1508358128 | Antonino Bucca | Emergency Medicine | 720 Eskenazi Ave Bldg 3, Indianapolis, IN 46202-5187 | 2018-05-30 |
| 1124518931 | Evan Mitchell Landry Tomkiewicz | Emergency Medicine | 720 Eskenazi Ave Fl Ft3, Indianapolis, IN 46202-5187 | 2018-05-16 |
| 1760907299 | Timothy John Howard | Emergency Medicine | 610 1/2 N Main Street, Apartment 1, Mishawaka, IN 46545 | 2017-08-05 |
| 1760913891 | Nathan Francis Marcinkowski | Emergency Medicine | 216 N 4th St Ste 205, Lafayette, IN 47901-1323 | 2017-03-21 |
| 1154777613 | Michael J Bojrab | Emergency Medicine | 6720 Kirkdale Dr, Fort Wayne, IN 46815-5524 | 2016-05-13 |
| 1114307063 | Grant Fabian Chernoby | Emergency Medicine | 701 N Senate Ave # B401, Indianapolis, IN 46202-3111 | 2015-06-05 |
| 1457730830 | Patrick Lee Studtman | Emergency Medicine | 615 N. Michigan Street, Emergency Department, South Bend, IN 46601-1033 | 2015-05-19 |
| 1861888430 | Enola Okonkwo | Emergency Medicine | 9785 Valley Springs Blvd, Fishers, IN 46037-8764 | 2015-04-10 |
| 1518355882 | Marlin R. Gray | Emergency Medicine | 925 N. County Rd., 1100e, Otwell, IN 47564 | 2015-01-08 |
| Find all providers with the same taxonomy | ||||
| City | MICHIGAN CITY |
| Zip Code | 46360 |
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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.