JAY PROCHNAU (NPI# 1366411878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366411878 |
| Entity Type | Individual |
| Full Name | JAY PROCHNAU |
| Credential | MD |
| Practice Address |
1500 Salem St Lafayette IN 47904-2164 |
| Mailing Address |
Po Box 5545 Lafayette IN 47903-5545 |
| Practice Telephone | 7654488000 |
| Practice Fax Number | 7654488564 |
| Mailing Telephone | 7654488000 |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2012-07-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
01060643A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | CAQH NUMBER | 11438471 | 01 |
| IN | 200536580 | 05 | |
| IN | ANTHEM PROVIDER NUMBER | 000000372081 | 01 |
| IN | PHCS PID NUMBER | 9333888 | 01 |
| Street Address |
1500 SALEM ST |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47904-2164 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568448876 | Tamara Loewen Hazbun | Emergency Medicine | 1500 Salem St, Lafayette, IN 47904-2164 | 2005-12-19 |
| 1801246467 | Jacqulyn Burgess | Registered Nurse | 1500 Salem St, Lafayette, IN 47904-2164 | 2016-06-15 |
| 1942656186 | Amanda Dehne | Registered Nurse | 1500 Salem St, Lafayette, IN 47904-2164 | 2016-05-06 |
| 1134527807 | Rebecca J Hauck | Registered Nurse | 1500 Salem St, Lafayette, IN 47904-2164 | 2014-12-12 |
| 1679977128 | Michael E Criswell | Clinical Nurse Specialist | 1500 Salem St, Lafayette, IN 47904-2164 | 2014-10-13 |
| 1962840785 | Amy Sue Mclaughlin | Registered Nurse | 1500 Salem St, Lafayette, IN 47904-2164 | 2013-06-14 |
| 1487920310 | Laurie L Lebegue | Specialist/Technologist, Other | 1500 Salem St, Lafayette, IN 47904-2164 | 2012-03-26 |
| 1356659403 | Leslie Anne Bentinganan | Family Medicine | 1500 Salem St, Lafayette, IN 47904-2164 | 2010-09-22 |
| 1154598563 | Tasbirul Islam | Internal Medicine | 1500 Salem St, Lafayette, IN 47904-2164 | 2008-05-14 |
| 1346413713 | Leslie E Harshman | Specialist/Technologist, Other | 1500 Salem St, Lafayette, IN 47904-2164 | 2008-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568998615 | Angela Hands | Physical Therapy Assistant | 1260 North 17th Street, Lafayette, IN 47904 | 2017-05-11 |
| 1366894164 | Kathryn Barnett | Behavioral Analyst | 2785 Cason St # 2, Lafayette, IN 47904 | 2016-07-06 |
| 1881972917 | Rest Assured, LLC | Durable Medical Equipment & Medical Supplies | 180 Professional Ct., Lafayette, IN 47904 | 2011-07-22 |
| 1144514233 | Michelle Cristin Singleton | Dietitian, Registered | 508 N 26th St, Lafayette, IN 47904 | 2011-06-06 |
| 1912134438 | Jean D Trammel | Marriage & Family Therapist | 2000 Greenburg St, Bldg B, Suite A, Lafayette, IN 47904 | 2009-06-11 |
| 1902946056 | Terry Richard Baker | Optometrist | 2300 Sagamore Parkway S, Lafayette, IN 47904 | 2007-02-07 |
| 1891862165 | Becki A Bowditch Inc | Social Worker | 2201 Ferry Street, Lafayette, IN 47904 | 2006-11-29 |
| 1326121849 | James Lowell Thomas | Pediatrics | 2300 Ferry St, Lafayette, IN 47904 | 2006-10-21 |
| 1700976719 | Michael Leonard Bagnoli | Dentist | 2020 Union Street, Suite 200, Lafayette, IN 47904 | 2006-10-13 |
| 1255428801 | Lynn Arlen Pestle | Dentist | 2550 Elmwood Avenue, Lafayette, IN 47904 | 2006-10-06 |
| Find all providers in zip 47904 | ||||
| Taxonomy Code | 207KA0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| Specialization | Allergy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013181858 | Unity Healthcare, LLC | Allergy & Immunology | 1345 Unity Pl, Suite 145a, Lafayette, IN 47905-5771 | 2008-04-14 |
| 1437208840 | Allergy Asthma & Immunology Center of Southwest Louisiana | Allergy & Immunology | 320 Settlers Trace Blvd, Lafayette, LA 70508 | 2007-01-09 |
| 1932178746 | Donald Eugene Clayton | Allergy & Immunology | 2600 Greenbush St, Lafayette, IN 47904 | 2006-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801027099 | Central Indiana Allergy LLC | Allergy & Immunology | 965 Emerson Pkwy Ste B, Greenwood, IN 46143-6274 | 2009-08-05 |
| 1700930252 | Sai R Karlapudi | Allergy & Immunology | 4505 N Wheeling Ave, Muncie, IN 47304-1284 | 2007-01-22 |
| 1588697759 | Allergy Associates of Central In | Allergy & Immunology | 8803 N Meridian St, Suite 100, Indianapolis, IN 46260-5300 | 2006-07-09 |
| 1962445528 | Sanjay C Patel | Allergy & Immunology | 9008 Indianapolis Blvd, Highland, IN 46322-2501 | 2006-06-13 |
| 1134184153 | David George Short | Allergy & Immunology | 1025 Michigan Avenue, Suite 215, Logansport, IN 46947-1594 | 2006-04-20 |
| 1285601278 | Nagarjuna R Ponugoti | Allergy & Immunology | 4779 S 7th St, Terre Haute, IN 47802-4559 | 2006-03-08 |
| 1558336230 | Damir Matesic | Allergy & Immunology | 2216 W Alto Rd, Kokomo, IN 46902-4840 | 2006-02-17 |
| 1356332001 | Carol K Fosso | Allergy & Immunology | 70 E 91st St Ste 204, Indianapolis, IN 46240-1564 | 2005-11-02 |
| 1982605937 | Peter M Rothman | Allergy & Immunology | 7920 W Jefferson Blvd, Suite 220, Fort Wayne, IN 46804 | 2005-08-02 |
| 1063413052 | Naresh J Patel | Allergy & Immunology | 7964 W. Jefferson Blvd., Fort Wayne, IN 46804-4140 | 2005-08-02 |
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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.