DR. INDIRA MOODUMANE (NPI# 1639181340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639181340 |
| Entity Type | Individual |
| Full Name | DR. INDIRA MOODUMANE |
| Credential | MD |
| Practice Address |
809 Meyers Baker Rd Suite 1 London KY 40741-3025 |
| Mailing Address |
Po Box 689 London KY 40743-0689 |
| Practice Telephone | 6068647337 |
| Practice Fax Number | 6068783257 |
| Mailing Telephone | 6068647337 |
| Mailing Fax Number | 6068783257 |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2019-10-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 36054 | KY | Other Service Providers |
| Y | 208000000X | Pediatrics | 36054 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64039019 | 05 |
| Street Address |
809 MEYERS BAKER RD SUITE 1 |
| City | LONDON |
| State | KY |
| Zip Code | 40741-3025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003875709 | Parkway Pediatrics Psc | Pediatrics | 809 Meyers Baker Rd, Suite 1, London, KY 40741-3025 | 2006-03-21 |
| 1629080148 | Carla R. Phelps | Nurse Practitioner | 809 Meyers Baker Rd, Suite 1, London, KY 40741-3025 | 2006-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841244 | Emily Anne Simmons | Pharmacist | 1851 West Hwy 192, London, KY 40741 | 2020-11-06 |
| 1871104364 | Jarrod Lee Napier | Optometrist | 103 Chera Lyn Ln, London, KY 40741 | 2020-08-10 |
| 1295378792 | Rebekah Virginia Elaine Cloud | Nurse Practitioner | 1649 Ky- 192 W, London, KY 40741 | 2019-10-28 |
| 1215416581 | Mary Jean Nolan | Nurse Practitioner | 1649 W. Hwy 192, London, KY 40741 | 2018-08-08 |
| 1558849620 | Pinnacle Treatment Centers Ky-1, LLC | Substance Abuse Rehabilitation Facility | 312 Carrera Drive, London, KY 40741 | 2018-08-01 |
| 1710463435 | Pinnacle Treatment Centers Ky-i, LLC | Substance Abuse Rehabilitation Facility | 300 Carrera Drive, London, KY 40741 | 2018-07-16 |
| 1720591076 | Hillary Clark | Nurse Practitioner | 192 London Shopping Ctr Ste 2, London, KY 40741 | 2017-11-08 |
| 1760901979 | Ariel Siler | Counselor | 454 N. Mcwhorter St., Suite 1, London, KY 40741 | 2017-09-19 |
| 1598287161 | Young Smiles,llc | Clinic/Center | 324 Holly Lane, London, KY 40741 | 2017-07-14 |
| 1952727505 | Renew Recovery, LLC | Substance Abuse Rehabilitation Facility | 2645 N Laurel Rd Ste B, London, KY 40741 | 2014-03-06 |
| Find all providers in zip 40741 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407998347 | Madison Pediatrics, Inc. | Pediatrics | 55 Park Ave., Suite 210, London, OH 43140-1121 | 2007-02-13 |
| 1992855787 | Gregg M. Alexander | Pediatrics | 55 Park Ave Ste 210, London, OH 43140-1121 | 2007-01-12 |
| 1003875709 | Parkway Pediatrics Psc | Pediatrics | 809 Meyers Baker Rd, Suite 1, London, KY 40741-3025 | 2006-03-21 |
| 1730153701 | Hassan Mahmood | Pediatrics | 378 Thompson Poynter Rd, London, KY 40741-7238 | 2006-02-15 |
| 1962936351 | Piper Seyfrit | Pediatrics | 803 Meyers Baker Rd Ste 200, London, KY 40741-3040 | 2017-04-12 |
| 1841656139 | Allison Landoll | Pediatrics | 55 Park Ave, Suite 275, London, OH 43140-1170 | 2016-01-03 |
| 1912137720 | Memorial Hospital, Inc. | Pediatrics | 102 Professional Dr Ste 2, London, KY 40741-8857 | 2009-07-15 |
| 1548428097 | Cecile C. Del Mundo, Md, Pllc | Pediatrics | 202 W 7th St, Ste 201, London, KY 40741-1763 | 2008-05-30 |
| 1174682363 | London Pediatrics, Inc. | Pediatrics | 55 Park Ave, Ste 240, London, OH 43140-1121 | 2006-12-06 |
| 1689607095 | Indra Rastogi | Pediatrics | 202 W 7th St, Suite 200, London, KY 40741-1763 | 2006-07-09 |
| Find all providers in LONDON | ||||
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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.