MAOAC, LLC (NPI# 1730663923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730663923 |
| Entity Type | Organization |
| Organization Name | MAOAC, LLC |
| Practice Address |
8856 South St Fishers IN 46038-2911 |
| Practice Telephone | 3175161177 |
| Practice Fax Number | 3175165128 |
| Mailing Telephone | 3175161177 |
| Mailing Fax Number | 3175165128 |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2018-09-24 |
| Authorized Official Name | CASSY BRATCHER (OFFICE MANAGER) |
| Authorized Official Telephone | 3172136762 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 1427027283 | 05 | |
| IN | 1891162764 | 05 | |
| IN | 1760892749 | 05 | |
| IN | 1821290743 | 05 |
| Street Address |
8856 SOUTH ST |
| City | FISHERS |
| State | IN |
| Zip Code | 46038-2911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619447976 | Pratima Shrestha | Nurse Practitioner | 11680 Commercial Dr Ste 200, Fishers, IN 46038 | 2018-11-29 |
| 1295242782 | Monica Hengge | Counselor | 11650 Lantern Rd Ste 128, Fishers, IN 46038 | 2018-01-05 |
| 1912437146 | Aaron Justin Tai | Optometrist | 10967 Allisonville Rd Ste 120, Fishers, IN 46038 | 2017-06-20 |
| 1124411657 | Amy K Parris | Social Worker | 11650 N. Lantern Road, Suite 232, Fishers, IN 46038 | 2015-03-09 |
| 1174948202 | New Roots Behavior Strategies LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13448 Fulton Drive, Fishers, IN 46038 | 2014-02-26 |
| 1306195292 | Planned Parenthood of Indiana Fishers | Clinic/Center | 8937 Technology Drive, Fishers, IN 46038 | 2012-09-06 |
| 1720336647 | Heather Jo Handley | Physical Therapist | 11650 N. Lantern Road, Suite 235, Fishers, IN 46038 | 2012-08-27 |
| 1770866287 | Kristin Nicole Eckerle | Pharmacist | 13962 Boulder Canyon Drive, Fishers, IN 46038 | 2011-09-21 |
| 1518267830 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 10312 Allisonville Rd, Fishers, IN 46038 | 2010-11-02 |
| 1316195316 | Barbara Elizabeth Rucker | Psychologist | 13179 Huff Blvd, Fishers, IN 46038 | 2008-09-03 |
| Find all providers in zip 46038 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346477247 | Ayesha Nichols | Psychiatry & Neurology | 1111 W. 10th Street, # A212, Indianapolis, IN 46202 | 2009-06-18 |
| 1487660981 | Brion Alan Bertsch | Psychiatry & Neurology | 9260 E 1125 S, Fairmount, IN 46928-9585 | 2006-08-01 |
| 1770669137 | Camila Libel Arnaudo | Psychiatry & Neurology | 727 W 2nd St, Bloomington, IN 47403-2209 | 2006-10-28 |
| 1194736868 | Sean Joseph O'connor | Psychiatry & Neurology | 1481 W 10th St, Psychiatry 116p, Indianapolis, IN 46202-2803 | 2006-08-10 |
| 1144274275 | Don A Marshall Jr. | Psychiatry & Neurology | 3010 E State Blvd, Sutie 100, Fort Wayne, IN 46805-4700 | 2006-05-22 |
| 1376591453 | David M Giles | Psychiatry & Neurology | 7165 Clearvista Way, Indianapolis, IN 46256-4621 | 2006-05-04 |
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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.