DR. ASHLEY BROOKE O'BANNON (NPI# 1629248711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629248711 |
| Entity Type | Individual |
| Full Name | DR. ASHLEY BROOKE O'BANNON |
| Other Name | DR. ASHLEY BROOKE O'BANNON LATINOVIC |
| Credential | MD |
| Practice Address |
1007 Lincolnway La Porte IN 46350-3201 |
| Practice Telephone | 2193262540 |
| Practice Fax Number | 2193262010 |
| Mailing Telephone | 2193262540 |
| Mailing Fax Number | 2193262010 |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2016-11-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
01070948A | IN | Allopathic & Osteopathic Physicians |
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
40481 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | MEDICARE PTAN | IN3131004 | 01 |
| Street Address |
1007 LINCOLNWAY |
| City | LA PORTE |
| State | IN |
| Zip Code | 46350-3201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699304907 | Katherine Elizabeth Davis | Occupational Therapist | 1007 Lincolnway, La Porte, IN 46350-3290 | 2020-04-07 |
| 1245864057 | Mitchell Steven Molenda | Nurse Practitioner | 1007 Lincolnway, La Porte, IN 46350-3290 | 2020-03-02 |
| 1295381580 | Samantha Burrows | Specialist/Technologist | 1007 Lincolnway, La Porte, IN 46350-3201 | 2019-08-13 |
| 1447805072 | Jill Renee Oscarson | Speech-Language Pathologist | 1007 Lincolnway, La Porte, IN 46350-3201 | 2019-08-09 |
| 1922663863 | Ashley Lysle Miller | Physical Medicine & Rehabilitation | 1007 Lincolnway, La Porte, IN 46350-3290 | 2019-05-07 |
| 1780249946 | Kyleigh Fife | Physical Therapist | 1007 Lincolnway, La Porte, IN 46350-3201 | 2019-05-03 |
| 1629542204 | Krista Marie Kerby | Occupational Therapist | 1007 Lincolnway, La Porte, IN 46350-3201 | 2019-01-16 |
| 1538659560 | Stephanie Maris Kadish | Nurse Practitioner | 1007 Lincolnway, La Porte, IN 46350-3290 | 2018-05-15 |
| 1346760873 | Cary Lynn Malstaff | Nurse Practitioner | 1007 Lincolnway, La Porte, IN 46350-3201 | 2017-06-26 |
| 1134652340 | Pathology Associates of Northwest Indiana Inc | Pathology | 1007 Lincolnway, La Porte, IN 46350-3201 | 2017-04-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871139246 | Carolyn Ann Perra | Pharmacist | 55 Pine Lake S.c., Laporte, IN 46350 | 2019-11-20 |
| 1306496492 | Trinity Healthcare Inc. | Occupational Therapist | 2002 Andrew Avenue, Laporte, IN 46350 | 2019-09-19 |
| 1184136665 | Diane Margaret Rich | Physical Therapist | 1643 S Willow Bend Dr, La Porte, IN 46350 | 2017-10-24 |
| 1114460102 | Judith Marie Fitzhugh | Dietitian, Registered | 1775 S. Basswood Trail, Laporte, IN 46350 | 2016-11-23 |
| 1568916971 | Total Renal Care, Inc. | Clinic/Center | 1406 E Lincolnway, Ste A, La Porte, IN 46350 | 2016-08-15 |
| 1083079008 | Irene Torres | Nurse Practitioner | 1407 Lincolnway, La Porte, IN 46350 | 2015-12-17 |
| 1124422910 | Becky Alwood-wallace | Occupational Therapist | 1203 Washington Street, Iu Health La Porte Hospital Wellness & Rehabilitation, La Porte, IN 46350 | 2014-10-22 |
| 1881001527 | Johnson Memorial Hospital | Skilled Nursing Facility | 3530 Monroe Street, La Porte, IN 46350 | 2014-07-15 |
| 1306268941 | Tiffany Anne Satterfield | Physical Therapy Assistant | 194 S 400 E, Laporte, IN 46350 | 2014-01-16 |
| 1801122239 | Mary Barbara Backer | Internal Medicine | 301 Willow Bend Dr, La Porte, IN 46350 | 2009-10-20 |
| Find all providers in zip 46350 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134652340 | Pathology Associates of Northwest Indiana Inc | Pathology | 1007 Lincolnway, La Porte, IN 46350-3201 | 2017-04-05 |
| 1619323813 | La Porte Hospital Company LLC | Pathology | 1007 Lincolnway, La Porte, IN 46350-3201 | 2016-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225558125 | Nichole Landry Lepage | Pathology | 350 West 11th Street, Suite 4083, Indianapolis, IN 46202 | 2017-06-21 |
| 1871904532 | Michael J Hwang | Pathology | 350 W 11th St Rm 4080, Indianapolis, IN 46202-4108 | 2014-05-15 |
| 1720405814 | Jared Cobb | Pathology | 350 W 11th St Rm 4083, Indianapolis, IN 46202-4108 | 2014-03-26 |
| 1629337522 | Christin Hweisi Tsao | Pathology | 350 W 11th St Rm 5034, Indianapolis, IN 46202-4108 | 2012-05-11 |
| 1275779027 | Rick Bains | Pathology | 2560 N. Shadeland Ave., Ste. A, Indianapolis, IN 46219-1706 | 2008-12-29 |
| 1164677423 | Phoenix Clinical Labs Inc | Pathology | 8755 Guion Rd, Indianapolis, IN 46268-3047 | 2008-11-28 |
| 1457502841 | Swarna S Sikdar | Pathology | 430 Indiana Ave, Apt #326, Indianapolis, IN 46202 | 2008-10-04 |
| 1780848812 | Dean Harvey Lauer | Pathology | 2303 Throughwoods Dr, Valparaiso, IN 46385-7303 | 2008-07-17 |
| 1063612976 | Isabelle Ann Buehl | Pathology | 7994 West Road 75 North, Bargersville, IN 46106-9518 | 2007-07-19 |
| 1639378250 | Christopher Michael Carter | Pathology | 601 W 2nd St Rm 216, Bloomington, IN 47403 | 2007-07-13 |
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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.