PEDIATRIC & INTERNAL MEDICINE CENTER (NPI# 1386674513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386674513 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC & INTERNAL MEDICINE CENTER |
| Practice Address |
1434 Chester Blvd Richmond IN 47374-1947 |
| Practice Telephone | 7659665527 |
| Practice Fax Number | 7659665527 |
| Mailing Telephone | 7659665527 |
| Mailing Fax Number | 7659665527 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2008-04-23 |
| Authorized Official Name | PAMELA CAWOOD (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 7659665527 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 50000450A | IN | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | 50000450A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CLIA# | 15D0360467 | 01 | |
| OH | 0121808 | 05 | |
| IN | 100255760A | 05 | |
| MEDICARE RR | CI9605 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | PEDIATRIC & INTERNAL MEDICINE CENTER, P.C. | 1434 Chester Blvd, Richmond, IN 47374 |
| Street Address |
1434 CHESTER BLVD |
| City | RICHMOND |
| State | IN |
| Zip Code | 47374-1947 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700888955 | Rohit Bawa | Otolaryngology | 1434 Chester Blvd, Richmond, IN 47374-1947 | 2005-06-01 |
| 1689231664 | Gina N Goodman | Nurse Practitioner | 1434 Chester Blvd, Richmond, IN 47374-1947 | 2019-05-24 |
| 1457706434 | Amanda Daggett | Dermatology | 1434 Chester Blvd, Richmond, IN 47374-1947 | 2016-04-27 |
| 1871993485 | Stacy Borden | Audiologist | 1434 Chester Blvd, Richmond, IN 47374-1947 | 2014-09-02 |
| 1427491984 | Leigh Grace Stone | Dermatology | 1434 Chester Blvd, Richmond, IN 47374-1947 | 2013-04-15 |
| 1538456462 | Jason Evan Casselman | Internal Medicine | 1434 Chester Blvd, Reid Ent, Richmond, IN 47374-1947 | 2011-06-29 |
| 1386881456 | Kristy L Carter | Physician Assistant | 1434 Chester Blvd, Richmond, IN 47374-1947 | 2009-01-12 |
| 1750531950 | Laura Lea Fragomeni | Audiologist | 1434 Chester Blvd, Richmond, IN 47374-1947 | 2008-09-24 |
| 1326297284 | Reid Physician Associates, Inc. | Internal Medicine | 1434 Chester Blvd, Richmond, IN 47374-1947 | 2008-09-16 |
| 1598927485 | Amber Sadenwater Wolsiefer | Audiologist | 1434 Chester Blvd, Reid Ent, Richmond, IN 47374-1947 | 2008-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245724566 | Meridian Health Services Corp | Substance Abuse Rehabilitation Facility | 498 Nw 18th St., Bldg. 416, Suite A, Richmond, IN 47374 | 2018-06-20 |
| 1699274472 | Happy Hearts Home Care Corp | In Home Supportive Care | 335 Sw 17th Street, Richmond, IN 47374 | 2018-02-07 |
| 1922528504 | Erin A Chung | Internal Medicine | 1050 Reid Parkway, Suite 300, Reid Hospital Family Medicine Residency, Richmond, IN 47374 | 2017-06-23 |
| 1023538899 | Andrea Dengler | Registered Nurse | 1501 Chester Blvd., Reid Urgent Care, Richmond, IN 47374 | 2017-06-22 |
| 1497284186 | Lindsay A Worley | Nurse Practitioner | 1050 Reid Pkwy, Ste. 325, Urological Care, Richmond, IN 47374 | 2017-06-07 |
| 1689112039 | Shantil Dickerson | Physical Therapist | 22 Nw 11th St., Richmond, IN 47374 | 2017-02-06 |
| 1073058772 | Meridian Health Services Corp | Substance Abuse Rehabilitation Facility | 498 Nw 18th St Bldg 416, Richmond, IN 47374 | 2017-01-04 |
| 1538564216 | Lauren Joos | Physician Assistant | 1380 Lakeview Court, Richmond, IN 47374 | 2014-10-23 |
| 1588074421 | Emily Rutherford | Pharmacist | 2057 Chester Blvd, Richmond, IN 47374 | 2014-04-30 |
| 1922357870 | Elizabeth Ann Mullins | Social Worker | 301 South 4th St., Richmond, IN 47374 | 2012-09-06 |
| Find all providers in zip 47374 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1003421538 | Doctors Who Care Pllc | Internal Medicine | 1601 Main St Ste 309, Richmond, TX 77469-3230 | 2020-09-11 |
| 1093367245 | Maya Susan Varkey | Internal Medicine | 8119 Cheyenne Hills Trl, Richmond, TX 77406-1626 | 2019-07-09 |
| 1780164426 | Kelly Clinic | Internal Medicine | 5503 Fm 359 Rd Ste C, Richmond, TX 77406-7835 | 2018-08-21 |
| 1013411032 | Graham Philip Mcrary | Internal Medicine | Vcuhs Dept of Pm&r, 9860667, 1250 E. Marshall Street, Richmond, VA 23298-0000 | 2018-03-23 |
| 1306340153 | Eric Sheldon Jacobson | Internal Medicine | 2956 Hathaway Rd, Apt. 1101, Richmond, VA 23225 | 2018-03-19 |
| 1922528504 | Erin A Chung | Internal Medicine | 1050 Reid Parkway, Suite 300, Reid Hospital Family Medicine Residency, Richmond, IN 47374 | 2017-06-23 |
| 1801322821 | Adnan Alam Khan | Internal Medicine | 1721 Hanover Ave Unit A, Richmond, VA 23220-3505 | 2017-05-11 |
| 1568900439 | John Edward Tysell Jr. | Internal Medicine | 437 Carlston Street, Richmond, CA 94805 | 2017-02-10 |
| 1457898702 | Michael Ngo D.o. American Board of Internal Medicine Certified Pllc | Internal Medicine | 11130 Drumadoon Dr, Richmond, TX 77407-2036 | 2017-01-25 |
| 1346796091 | Thaer Saqer Mustafa Abdelfattah | Internal Medicine | Vcuhs Dept of Gastroenterology Fellowship, 980509, 1250 E. Marshall Street, Richmond, VA 23298-0509 | 2016-08-31 |
| Find all providers in RICHMOND | ||||
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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.