BLOOMINGTON ENT PC (NPI# 1306816665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306816665 |
| Entity Type | Organization |
| Organization Name | BLOOMINGTON ENT PC |
| Practice Address |
1791 W 3rd St Bloomington IN 47404-5029 |
| Practice Telephone | 8123351300 |
| Practice Fax Number | 8123350300 |
| Mailing Telephone | 8123351300 |
| Mailing Fax Number | 8123350300 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2008-04-15 |
| Authorized Official Name | JESSE PHILLIPS (OWNER) |
| Authorized Official Telephone | 8123351300 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 01040385A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM BCBS | 000000209641 | 01 |
| IN | AETNA | 5818093 | 01 |
| IA | CIGNA | 2440326 | 01 |
| IN | SIHO | 546541P | 01 |
| Street Address |
1791 W 3RD ST |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47404-5029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467847475 | Tracy Lee | Podiatrist | 1791 W 3rd St, Bloomington, IN 47404-5029 | 2015-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013526631 | Sandra Clark | Counselor | 205 N College Avenue, Suite 210a, Bloomington, IN 47404 | 2020-07-29 |
| 1750926085 | Michelle Christine Dustin | Nurse Practitioner | 610 N Morton Street, Bloomigton, IN 47404 | 2019-11-11 |
| 1316440191 | Julie D'argent | Psychologist | 205 N College Ave Ste 430, Bloomington, IN 47404 | 2018-03-17 |
| 1770966467 | Richard Lawson | Counselor | 1117 North Jackson Street, Bloomington, IN 47404 | 2015-06-30 |
| 1477952109 | Teresa R. Foster | Social Worker | 205 N. College Avenue, Suite 210b, Bloomington, IN 47404 | 2014-08-19 |
| 1073879532 | First Health Plus, Inc | Clinic/Center | 104 North Curry Pike, Bloomington, IN 47404 | 2012-04-09 |
| 1497079982 | Tera Dee Nance | Counselor | 101 W. Kirkwood Avenue, Suite 009 Fountain Square Mall, Bloomington, IN 47404 | 2010-03-26 |
| 1962643114 | Pathways Counseling Center | Community/Behavioral Health | 3866 W. Third Street, Bloomington, IN 47404 | 2009-03-18 |
| 1932358595 | Catherine Elizabeth Batka | Psychologist | 101 W. Kirkwood Ave, Suite 103, Bloomington, IN 47404 | 2008-09-18 |
| 1396901005 | Kijin Woo | Dentist | 330 N Jacob Drive, Bloomington, IN 47404 | 2008-08-01 |
| Find all providers in zip 47404 | ||||
| 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 |
|---|---|---|---|---|
| 1437587839 | Susan Emmerson | Otolaryngology | 1303 E Washington St, Bloomington, IL 61701-4228 | 2013-10-22 |
| 1689769929 | John Hooton Seward | Otolaryngology | 3511 Saddlebrook Ct, Bloomington, IN 47401-8549 | 2006-10-03 |
| 1326050881 | Thomas C Ocheltree | Otolaryngology | 1404 Eastland Dr Ste 209, Bloomington, IL 61701-7904 | 2006-08-13 |
| 1063442457 | Finn R Amble | Otolaryngology | 3801 General Electric Rd Ste 4, Bloomington, IL 61704 | 2006-07-03 |
| 1497014740 | Robert Zhibo Yang | Otolaryngology | 7920 Cedar Ave S, Bloomington, MN 55425-1207 | 2012-05-07 |
| 1487881058 | Osf Multispecialty Group - Eastern Region, LLC | Otolaryngology | 1701 E College Ave, Bloomington, IL 61704-2101 | 2009-06-22 |
| 1447388772 | Dennis Lee Md Ltd | Otolaryngology | 107 N Regency Dr, Bloomington, IL 61701-3515 | 2007-02-28 |
| 1699854745 | Ent Associates of Southern Indiana, P.C. | Otolaryngology | 2920 Mcintyre Dr, Suite 350, Bloomington, IN 47403-4221 | 2006-11-02 |
| 1992813174 | Robert T Russell | Otolaryngology | 1404 Eastland Dr Ste 209, Bloomington, IL 61701-7904 | 2006-08-28 |
| 1912935370 | Jeffrey A Block | Otolaryngology | 7920 Old Cedar Ave S, Bloomington, MN 55425-1207 | 2006-06-28 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 47404 |
Please comment or provide details below to improve the information on BLOOMINGTON ENT PC.
| 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.