MAKENZIE STALETS (NPI# 1578178331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578178331 |
| Entity Type | Individual |
| Full Name | MAKENZIE STALETS |
| Credential | PA-C |
| Practice Address |
8205 E 56th St Ste 100 Indianapolis IN 46216-1069 |
| Mailing Address |
120 W Stop 11 Rd Indianapolis IN 46217-4225 |
| Practice Telephone | 3173538985 |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2020-09-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
IN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
8205 E 56TH ST STE 100 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46216-1069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184835852 | Toby A Zirkle | Family Medicine | 8205 E 56th St Ste 100, Indianapolis, IN 46216 | 2007-05-24 |
| 1942581889 | Christina Inteso | Pharmacist | 8205 E 56th St Ste 100, Indianapolis, IN 46216-1069 | 2011-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801435292 | Wickshire Fort Harrison Opco LLC | Assisted Living Facility | 8025 Doubleday Drive, Indianapolis, IN 46216 | 2020-01-02 |
| 1851875546 | Andrew David Power | Dentist | 5869 Lawton Loop East Drive, Indianapolis, IN 46216 | 2018-09-19 |
| 1366938417 | Alidde Alouidor | Social Worker | 9801 E 59th St, Indianapolis, IN 46216 | 2018-07-02 |
| 1548779663 | Fresenius Medical Care Indiana, LLC | Clinic/Center | 9140 Harrison Park Ct, Indianapolis, IN 46216 | 2017-09-20 |
| 1922178995 | Physiotherapy Associates | Physical Therapist | 5665 North Post Rd. Suite 100, Indianapolis, IN 46216 | 2006-11-08 |
| 1871562645 | Richard Clark Perry | Internal Medicine | 8205 E 56th Street, Suite 100, Indianapolis, IN 46216 | 2006-03-15 |
| 1902420532 | Carole Christine Corder | Dietitian, Registered | 8205 E 56th St, Suite 100, Indianapolis, IN 46216 | 2020-05-29 |
| 1821301300 | Robin Girdhar | Internal Medicine | 8205 E 56th St, Ste 100, Indianapolis, IN 46216 | 2010-07-26 |
| 1306949086 | Hook Superx LLC | Durable Medical Equipment & Medical Supplies | 5605 N Post Rd, Indianapolis, IN 46216-1002 | 2006-09-07 |
| 1992790299 | Qin Wang-joy | Internal Medicine | 8205 E 56th St, Suite 250, Indianapolis, IN 46216-1003 | 2005-09-13 |
| Find all providers in zip 46216 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634936 | Brilyn Michelle Banister | Physician Assistant | 8443 Cabin Creek Dr Apt G, Indianapolis, IN 46237-6330 | 2020-09-17 |
| 1386290625 | Douglas R Day | Physician Assistant | 1701 N Senate Blvd # Ag373a, Indianapolis, IN 46202-1239 | 2019-08-13 |
| 1841851409 | Rachel Jagrowski | Physician Assistant | 1801 N Senate Blvd Ste 700, Indianapolis, IN 46202-1177 | 2019-06-25 |
| 1407311814 | William Peter Thompson | Physician Assistant | 1801 N Capitol Ave # Npe120, Indianapolis, IN 46202-1217 | 2019-02-11 |
| 1912492679 | Katherine Barrett Tenbarge | Physician Assistant | 1800 N Capitol Ave # E140, Indianapolis, IN 46202-1218 | 2018-06-26 |
| 1154843704 | Jennifer Trapuzzano | Physician Assistant | 1801 N Senate Blvd Ste 310, Indianapolis, IN 46202-1196 | 2017-07-14 |
| 1154879666 | Grace Schultz | Physician Assistant | 1408 Broadway St Apt F, Indianapolis, IN 46202-2744 | 2016-09-13 |
| 1477925071 | Samantha Kitcoff | Physician Assistant | 8180 Clearvista Pkwy Ste 100, Indianapolis, IN 46256 | 2015-10-22 |
| 1386040046 | Maham Mushtaq | Physician Assistant | 5759 James Blair Dr, Indianapolis, IN 46234-3226 | 2014-11-07 |
| 1285030924 | Margaret Anne Voelker-park | Physician Assistant | 550 University Blvd Unit 3240, Indianapolis, IN 46202-5250 | 2014-11-07 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46216 |
Please comment or provide details below to improve the information on MAKENZIE STALETS.
| 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.