DR. DEEPAK REDDY (NPI# 1710119540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710119540 |
| Entity Type | Individual |
| Full Name | DR. DEEPAK REDDY |
| Credential | M.D. |
| Practice Address |
53880 Carmichael Dr South Bend IN 46635-1567 |
| Practice Telephone | 5742479441 |
| Practice Fax Number | 5742479442 |
| Mailing Telephone | 5742479441 |
| Mailing Fax Number | 5742479442 |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2015-10-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
01075845A | IN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285047977 | Deepak Reddy | Psychiatry & Neurology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-06-10 |
| 1518087568 | Deepak Kolagatla Reddy | Emergency Medicine | 38935 Ann Arbor Rd, Livonia, MI 48150-3397 | 2007-03-30 |
| Street Address |
53880 CARMICHAEL DR |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46635-1567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699764308 | Gary L. Armock | Physician Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2005-10-14 |
| 1972113496 | Jennifer Miller | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-10 |
| 1558971101 | Michelle Eichstedt | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-07 |
| 1316557390 | Kimberly Kinney | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-05 |
| 1023628005 | Melanie Daggy | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-05 |
| 1922618040 | Amy Tarwacki | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-04 |
| 1730720301 | Mackenzie S Warrick | Physician Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2019-10-03 |
| 1952950883 | Kyle Thomas Matheson | Physical Therapist | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2019-09-04 |
| 1851949440 | Karen Elizabeth Schneider-wensell | Physical Therapist | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2019-08-28 |
| 1174171763 | Elizabeth Anne Sullivan | Occupational Therapist | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2019-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295078228 | Michael Pfeiffer | Otolaryngology | 6301 University Commons Ste 360, South Bend, IN 46635 | 2013-03-27 |
| 1679833438 | Whitney Moore | Physical Therapy Assistant | 2012 Ironwood Circle, Suite 230, Circle Centre Building, South Bend, IN 46635 | 2012-05-25 |
| 1992917637 | Elly May Wynia | Social Worker | 53700 Generations Drive, Suite 200, South Bend, IN 46635 | 2007-05-04 |
| 1891917282 | Lifetime Dental Careof Indiana, PC | Dentist | 1605 North Ironwood, South Bend, IN 46635 | 2007-05-03 |
| 1750502878 | Tyrone Arteese Armstead | Pharmacist | 3355 Douglas Rd, South Bend, IN 46635 | 2007-05-02 |
| 1013033794 | Bradley Richard Swanson | Dentist | 54505 26th Street, Unit E, South Bend, IN 46635 | 2007-03-22 |
| 1225185739 | Michael J. O'connell D.o. Inc | Family Medicine | 17960 Cleveland Road, South Bend, IN 46635 | 2007-01-05 |
| 1346300365 | Chad Fulton Harrington | Dentist | 3340 Douglas Rd., South Bend, IN 46635 | 2006-12-11 |
| 1346313236 | Dr Shawn R Long Dds PC | Dentist | 16329 State Rd 23, South Bend, IN 46635 | 2006-11-16 |
| 1134206576 | Kearn David Hinchman | Psychiatry & Neurology | 53779 Generations Drive, Suite 1, South Bend, IN 46635 | 2006-11-01 |
| Find all providers in zip 46635 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710969712 | Henry W. Deleeuw | Orthopaedic Surgery | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2005-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548768815 | Spine Cin of Indianapolis LLC | Orthopaedic Surgery | 120 E Market St Ste 1265, Indianapolis, IN 46204-3250 | 2018-01-31 |
| 1174021950 | Joint Replacement Cin of Indianapolis LLC | Orthopaedic Surgery | 120 E Market St Ste 1272, Indianapolis, IN 46204-3250 | 2018-01-26 |
| 1508220633 | Indiana Spine Group, PC | Orthopaedic Surgery | 747 E. County Line Rd., Suite L, Greenwood, IN 46143-1082 | 2016-04-05 |
| 1144667635 | Indiana Spine Group, PC | Orthopaedic Surgery | 1115 N. Ronald Reagan Pkwy., Suite 148, Avon, IN 46123-6913 | 2013-05-24 |
| 1457534497 | Orthopaedic Spine Center PC | Orthopaedic Surgery | 5255 E.stop 11 Road, Suite 250, Indianapolis, IN 46237-6343 | 2007-12-13 |
| 1689872152 | Spine & Musculoskeletal Center PC | Orthopaedic Surgery | 2020 E Columbus Drive, Suite B, East Chicago, IN 46312-3078 | 2007-07-06 |
| 1366654410 | Michael J. Hartman, Md, PC | Orthopaedic Surgery | 801 Mac Arthur Blvd, Suite 304, Munster, IN 46321 | 2007-05-03 |
| 1356485825 | Southern Indiana Orthopedics, Inc | Orthopaedic Surgery | 633 East Tipton, Seymour, IN 47274-2192 | 2007-02-17 |
| 1851494371 | Northwest Indiana Spinal Surgery, P.C. | Orthopaedic Surgery | 9235 Broadway, Merrillville, IN 46410-7046 | 2006-09-07 |
| 1407898570 | Gregory S. Hellwarth | Orthopaedic Surgery | 1400 Highland Rd Ste 1, Richmond, IN 47374-8810 | 2006-06-12 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46635 |
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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.