TRI STATE IMMUNIZATION GROUP INC (NPI# 1477993939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477993939 |
| Entity Type | Organization |
| Organization Name | TRI STATE IMMUNIZATION GROUP INC |
| Other Organization Name | PASSPORT HEALTH OF EVANSVILLE |
| Practice Address |
101 Plaza East Boulevard Ste 107 Evansville IN 47715-2804 |
| Mailing Address |
101 Plaza East Blvd Ste 107 Evansville IN 47715-2804 |
| Practice Telephone | 8124026000 |
| Practice Fax Number | 8124026012 |
| Mailing Telephone | 8124026000 |
| Mailing Fax Number | 8124026012 |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2013-06-29 |
| Authorized Official Name | SCOTT R BURGESS (OWNER) |
| Authorized Official Telephone | 8124026000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163W00000X | Registered Nurse | Nursing Service Providers |
| Other Name | Type Code |
|---|---|
| Passport Health of Evansville | Doing Business As Name - Organization |
| Street Address |
101 PLAZA EAST BOULEVARD STE 107 |
| City | EVANSVILLE |
| State | IN |
| Zip Code | 47715-2804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528585 | Shannon Allcron | Pharmacist | 6770 E. Virginia St., Evansville, IN 47715 | 2020-11-03 |
| 1609339910 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 1201 Cross Pointe Place, Evansville, IN 47715 | 2019-04-12 |
| 1497229223 | Hubert Family Dentistry LLP | Dentist | 6225 E Columbia St., Evansville, IN 47715 | 2019-01-15 |
| 1083110373 | Fyi Healthcare, LLC | Registered Nurse | 12000 Highway 41 North, Evansville, IN 47715 | 2018-04-04 |
| 1962862755 | New Journeys Counseling Services, LLC | Community/Behavioral Health | 4929 River Wind Pointe Drive, Evansville, IN 47715 | 2016-03-07 |
| 1558702456 | Jennifer Hoelter | Pharmacist | 5000 E Virginia St, Walgreens District Office, Evansville, IN 47715 | 2013-07-09 |
| 1952649402 | Courtney Ingold | Music Therapist | 621 E Cullen Ave, Suite 118, Evansville, IN 47715 | 2013-01-17 |
| 1922378041 | Sherry A. Fisher | Counselor | 4929 Riverwind Pointe Dr Ste 102, Evansville, IN 47715 | 2012-01-05 |
| 1710275912 | Tonja Leana Winekauf | Nurse Practitioner | 6211 E Waterford Blvd, Evansville Health Care Center, Evansville, IN 47715 | 2011-07-21 |
| 1003083437 | Allcare Dental & Dentures of In PC | Dentist | 1031 N. Green River Rd., Suite 104, Evansville, IN 47715 | 2008-05-14 |
| Find all providers in zip 47715 | ||||
| Taxonomy Code | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346848132 | Katelyn Wendt | Registered Nurse | 105 S Madison St, Evansville, WI 53536-1365 | 2020-10-13 |
| 1386262392 | Barbara Jo Juarez | Registered Nurse | 6320 Cole Creek Rd, Evansville, WY 82636-9827 | 2020-07-07 |
| 1588284566 | Makenzie Schoenenberger | Registered Nurse | 8036 N Cemetery Rd, Evansville, WI 53536-9308 | 2020-04-20 |
| 1699326520 | Krista Marie Neuman | Registered Nurse | 1033 E Mount Pleasant Rd Ste D, Evansville, IN 47725-7149 | 2019-09-23 |
| 1467902940 | Kelli Hatcher | Registered Nurse | 1221 S Parker Dr, Evansville, IN 47714-3139 | 2016-10-10 |
| 1063869857 | Heather Lucas Webber | Registered Nurse | 2323 Selzer Rd, Evansville, IN 47712-3879 | 2016-05-21 |
| 1336443878 | At Home Rehab and Nursing Inc | Registered Nurse | 3328 Oaklyn Dr, Evansville, IN 47711-7313 | 2010-12-25 |
| 1467699512 | Laura M Carlton | Registered Nurse | 4550 W Lloyd Expy, Evansville, IN 47712-6515 | 2009-01-12 |
| 1093951675 | Patrick W. Greaney | Registered Nurse | 6310 Little Schaefer Rd., Evansville, IN 47720 | 2009-01-02 |
| 1356488555 | Velvet Dawn Locklin | Registered Nurse | 443 Curtiss Street, Evansville, WY 28636-0000 | 2007-01-30 |
| Find all providers in EVANSVILLE | ||||
| City | EVANSVILLE |
| Zip Code | 47715 |
Please comment or provide details below to improve the information on TRI STATE IMMUNIZATION GROUP INC.
| 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.