ATHELITE ORTHOPEDICS AND SPORTS MEDICINE, LLC (NPI# 1417287970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417287970 |
| Entity Type | Organization |
| Organization Name | ATHELITE ORTHOPEDICS AND SPORTS MEDICINE, LLC |
| Practice Address |
365 S Park Ridge Rd Suite 102 Bloomington IN 47401-8361 |
| Practice Telephone | 8128222675 |
| Practice Fax Number | 8128222679 |
| Mailing Telephone | 8128222675 |
| Mailing Fax Number | 8128222679 |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2010-01-06 |
| Authorized Official Name | DOUGLAS ALAN FLORY (MEMBER) |
| Authorized Official Telephone | 8128222675 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
1052068 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200272920 | 05 |
| Street Address |
365 S PARK RIDGE RD SUITE 102 |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47401-8361 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740765791 | Holly G Carter | Physical Therapist | 3607 Heirloom Dr, Bloomington, IN 47401 | 2018-09-26 |
| 1285116657 | Kimberly D Bergan | Occupational Therapist | 3607 S Heirloom Dr, Bloomington, IN 47401 | 2018-09-03 |
| 1255836813 | Erin Kathleen Sain | Nurse Practitioner | 326 W Woodcrest Drive, Bloomington, IN 47401 | 2018-03-27 |
| 1881104289 | Ev Bloomington Limited Partnership | Assisted Living Facility | 3607 South Heirloom Drive, Bloomington, IN 47401 | 2017-10-11 |
| 1619496536 | Kirsten N Neely | Physical Therapist | 2604 E. Creek's Edge Dr., Bloomington, IN 47401 | 2017-09-12 |
| 1023533908 | Hoosier United Therapy Service LLC | Physical Therapist | 2801 E Plateau Place, Bloomington, IN 47401 | 2017-08-11 |
| 1194127381 | Ann Marie Neeley | Lactation Consultant, Non-RN | 2458 South Walnut Street, Bloomington, IN 47401 | 2014-09-19 |
| 1518397801 | Indiana Spine and Sports Inc. | Chiropractor | 418 S Walnut St Suite C, Bloomington, IN 47401 | 2013-11-22 |
| 1053654574 | William Robblee Anderson | Obstetrics & Gynecology | 2625 E. Spicewood Ct., Bloomington, IN 47401 | 2013-04-03 |
| 1285979377 | Jenna Marie Dale | Optometrist | 322 S. Woodcrest Drive Precision Eye Group, Bloomington, IN 47401 | 2012-11-30 |
| Find all providers in zip 47401 | ||||
| Taxonomy Code | 207XX0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Foot and Ankle Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, foot and ankle surgeons deal with adult reconstructive foot and ankle surgery, adult foot and ankle trauma, sports medicine foot and ankle, and children's foot and ankle reconstructive surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: title modified, definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. ACGME Accredited Residency Program Requirements: 1 year of training with 5 years Orthopedic Surgery for a total of 6 years. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801181920 | Shaun Kink | Orthopaedic Surgery | 1111 Trinity Ln Ste 111, Bloomington, IL 61704-8112 | 2011-06-16 |
| 1912984915 | Ross Paskoff | Orthopaedic Surgery | 8100 Northland Dr, Bloomington, MN 55431-4800 | 2005-12-30 |
| 1013902089 | Matthew A Parmenter | Orthopaedic Surgery | 2920 Mcintyre Dr, Suite 100, Bloomington, IN 47403-4221 | 2005-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801235429 | Adam Michael Huff | Orthopaedic Surgery | 1400 N Ritter Ave Ste 510, Indianapolis, IN 46219 | 2013-06-17 |
| 1366762718 | Advanced Orthopaedic Foot and Ankle Clinic of Indiana Inc | Orthopaedic Surgery | 1438 Aggie Ln, Indianapolis, IN 46260-4098 | 2010-06-08 |
| 1295908929 | Jeffrey Schabler | Orthopaedic Surgery | 2113 E 62nd St # 210, Indianapolis, IN 46220-2311 | 2008-04-02 |
| 1407841463 | Wendy K Kennedy | Orthopaedic Surgery | 1024 S 6th St, Suite 102, Terre Haute, IN 47807-5015 | 2005-09-15 |
| 1205294907 | Central Indiana Orthopedics, PC | Orthopaedic Surgery | 6920 Gatwick Dr, Suite 200, Indianapolis, IN 46241-9504 | 2016-02-09 |
| 1003148685 | Medical Specialists Inc., PC | Orthopaedic Surgery | 9034 Columbia Ave, Munster, IN 46321-2905 | 2010-02-05 |
| 1235462540 | Melanie Sanders | Orthopaedic Surgery | 1199 Hadley Rd, Mooresville, IN 46158-1788 | 2009-09-18 |
| 1982861522 | James Flynn | Orthopaedic Surgery | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2008-05-21 |
| 1588671788 | Steven A Herbst | Orthopaedic Surgery | 3600 W Bethel Ave, Muncie, IN 47304-5407 | 2006-08-01 |
| 1538187950 | Scott J Trumble | Orthopaedic Surgery | 2310 California Road, Elkhart, IN 46514-1228 | 2006-07-17 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 47401 |
Please comment or provide details below to improve the information on ATHELITE ORTHOPEDICS AND SPORTS MEDICINE, LLC.
| 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.