INDIANA PHYSICIAN MANAGEMENT-NORTHEAST, LLC (NPI# 1740431576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740431576 |
| Entity Type | Organization |
| Organization Name | INDIANA PHYSICIAN MANAGEMENT-NORTHEAST, LLC |
| Practice Address |
13861 Olio Rd Fishers IN 46037-3487 |
| Mailing Address |
4685 Reliable Pkwy Chicago IL 60686-0001 |
| Practice Telephone | 3178706716 |
| Practice Fax Number | 3178700499 |
| Mailing Telephone | 3178706716 |
| Mailing Fax Number | 3178700499 |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2013-04-18 |
| Authorized Official Name | STEWART BICK (PRESIDENT) |
| Authorized Official Telephone | 3178706716 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200924740 | 05 |
| Street Address |
13861 OLIO RD |
| City | FISHERS |
| State | IN |
| Zip Code | 46037-3487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538118849 | Brett M Mccullough | Internal Medicine | 13861 Olio Rd, Fishers, IN 46037-3487 | 2006-05-06 |
| 1013383397 | Rachel Berglund | Pharmacist | 13861 Olio Rd, Fishers, IN 46037-3487 | 2015-08-20 |
| 1689913907 | Breanna Moore | Dietitian, Registered | 13861 Olio Rd, Fishers, IN 46037-3487 | 2013-02-06 |
| 1689982803 | Adeshola A Afolabi | Registered Nurse | 13861 Olio Rd, Fishers, IN 46037-3487 | 2010-09-22 |
| 1821325028 | Mid America Clinical Laboratories, LLC | Clinical Medical Laboratory | 13861 Olio Rd, Fishers, IN 46037-3487 | 2009-11-09 |
| 1528250438 | Nahid Eftekhari Marsden | Obstetrics & Gynecology | 13861 Olio Rd, Fishers, IN 46037-3487 | 2007-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659994200 | Lake Meadows Licensee LLC | Assisted Living Facility | 11570 E 126th Street, Fishers, IN 46037 | 2020-05-18 |
| 1861059818 | Fishers Specialty Surgery Center, LLC | Clinic/Center | 14300 E 138th St, Fishers, IN 46037 | 2019-05-24 |
| 1033776604 | Diane M Gianfagna-meils | Reflexologist | 9117 Thoreau Court, Fishers, IN 46037 | 2019-05-20 |
| 1649796830 | Heartland Medical, LLC | Durable Medical Equipment & Medical Supplies | 12289 Harvest Glen Blvd, Fishers, IN 46037 | 2017-08-18 |
| 1578098703 | Galaxy Healthcare Services LLC | Home Health | 12262 Steepleview Ct, Fishers, IN 46037 | 2017-04-25 |
| 1386980472 | Brenda Lynn Thompson | Counselor | 8880 Jaywick Dr Apt 206, Fishers, IN 46037 | 2012-12-18 |
| 1972887941 | Molly E Bruvold | Pharmacist | 13741 East 116th Street, Fishers, IN 46037 | 2011-10-07 |
| 1588970867 | Marie C. Holt, Dds | Dentist | 7862 E. 96th St., Fishers, IN 46037 | 2010-08-25 |
| 1114157815 | Francis Edward Mcaree Jr. | Obstetrics & Gynecology | 10907 300 Yd. Dr, Fishers, IN 46037 | 2009-07-16 |
| 1740433820 | Robert Gerald Klitzman | Orthopaedic Surgery | 13100 E. 136th St., Suite 2000, Fishers, IN 46037 | 2008-11-03 |
| Find all providers in zip 46037 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346871217 | Nw Indiana Ep, LLC | Emergency Medicine | 7904 Cabela Dr, Hammond, IN 46324-2950 | 2020-01-30 |
| 1801383278 | Midwest Emergency Medicine, Inc. | Emergency Medicine | 520 S 7th Street, Er, Vincennes, IN 47591-1038 | 2018-04-20 |
| 1285994434 | Aaron Brooks Crofoot | Emergency Medicine | 229 W North Shore Dr, South Bend, IN 46617-1142 | 2012-05-22 |
| 1689842262 | James Scott Frasure | Emergency Medicine | 4030 W Breezewood Ct, Bloomington, IN 47404-9132 | 2008-02-15 |
| 1831290956 | Suzanne M Coleman | Emergency Medicine | 3124 E State Blvd Ste 2b, Fort Wayne, IN 46805-4763 | 2006-09-25 |
| 1194772681 | Paula Lange | Emergency Medicine | 3252 Tantara Bnd, Carmel, IN 46032-8733 | 2006-05-28 |
| 1982658886 | Robert L Goddard Jr. | Emergency Medicine | 817 W Rosewood Dr, Bloomington, IN 47404-1849 | 2006-05-22 |
| 1295796985 | Thomas S Spencer | Emergency Medicine | 104 E Culver Rd, Suite 103, Knox, IN 46534-2216 | 2006-03-31 |
| 1609844166 | Joseph V Lazzara | Emergency Medicine | 8633 N State Road 550, Bruceville, IN 47516-6096 | 2006-03-10 |
| 1427048099 | Mark M Walsh | Emergency Medicine | 801 E Lasalle, Emergency Department, South Bend, IN 46617-2814 | 2005-10-25 |
| Find all providers with the same taxonomy | ||||
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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.