PROFESSIONAL EMERGENCY PHYSICIANS INC (NPI# 1184731069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184731069 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL EMERGENCY PHYSICIANS INC |
| Practice Address |
353 N Oak St Columbia City IN 46725-1623 |
| Mailing Address |
2414 E State Blvd Suite 202 Fort Wayne IN 46805-4760 |
| Practice Telephone | 2602489000 |
| Mailing Telephone | 2604824440 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. THOMAS E GUTWEIN (PRESIDENT) |
| Authorized Official Telephone | 2604824440 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| X | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2517753 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992812861 | Professional Emergency Physicians Inc | Emergency Medicine | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2006-08-24 |
| 1528175411 | Professional Emergency Physicians Inc | Emergency Medicine | 2001 Stults Rd, Huntington, IN 46750-1291 | 2006-08-24 |
| 1215044102 | Professional Emergency Physicians Inc | Emergency Medicine | 401 N Sawyer Rd, Kendallville, IN 46755-2568 | 2006-08-24 |
| Street Address |
353 N OAK ST |
| City | COLUMBIA CITY |
| State | IN |
| Zip Code | 46725-1623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679571855 | Richard J Iarussi | Anesthesiology | 353 N Oak St, Columbia City, IN 46725-1623 | 2005-07-12 |
| 1376585695 | Northeast Indiana Pain Specialists, LLC | Anesthesiology | 353 N Oak St, Columbia City, IN 46725-1623 | 2006-06-12 |
| 1619917366 | Northeast Indiana Anesthesiology, PC | Anesthesiology | 353 N Oak St, Columbia City, IN 46725-1623 | 2006-06-08 |
| 1821083221 | Kathleen B Baeverstad | Emergency Medicine | 353 N Oak St, Columbia City, IN 46725-1623 | 2005-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659858652 | Brittany R Ianucilli | Behavior Technician | 1200 W Depoy Dr, Columbia City, IN 46725 | 2018-07-23 |
| 1467908012 | Andrew Ott, LLC | Community/Behavioral Health | 402 N. Washington St., Columbia City, IN 46725 | 2016-09-01 |
| 1972983641 | Chelsey Caldwell | Pediatrics | 1270 E State Road 205 Ste 230, Columbia City, IN 46725 | 2015-06-08 |
| 1861805541 | Piotr Swiatkowski | Physical Therapist | 1260 East State Road 205, Columbia City, IN 46725 | 2014-06-10 |
| 1952644080 | Yvonka L Lower | Respite Care | 2714e700s, Columbiacity, IN 46725 | 2013-03-27 |
| 1508125873 | Mary Margaret Cyrus | Massage Therapist | 3880 E Cider Mill Rd, Columbia City, IN 46725 | 2012-05-08 |
| 1831473834 | Abigail R West | Occupational Therapy Assistant | 612 N Washington St, Columbia City, IN 46725 | 2011-10-10 |
| 1033367123 | Amy K Sadler | Family Medicine | 1270 E S.r. 205, Suite 240, Columbia City, IN 46725 | 2008-09-03 |
| 1366590937 | Rebecca Leigh Corpuz | Physician Assistant | 885 Connexion Way, Suite 200, Columbia City, IN 46725 | 2007-01-08 |
| 1902919582 | Bart Andrew Benzinger | Optometrist | 402 W. Plaza Dr, Wal-mart Vision Center, Columbia City, IN 46725 | 2006-08-16 |
| Find all providers in zip 46725 | ||||
| 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 |
|---|---|---|---|---|
| 1033524590 | Jaime R Hajjari | Emergency Medicine | 1260 E State Road 205, Columbia City, IN 46725 | 2014-06-24 |
| 1821083221 | Kathleen B Baeverstad | Emergency Medicine | 353 N Oak St, Columbia City, IN 46725-1623 | 2005-09-13 |
| 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 | COLUMBIA CITY |
| Zip Code | 46725 |
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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.