LEANN MARIE STIDHAM (NPI# 1750543591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750543591 |
| Entity Type | Individual |
| Full Name | LEANN MARIE STIDHAM |
| Other Name | LEANN MARIE GERKIN |
| Credential | M.D. |
| Practice Address |
500 W Votaw St Portland IN 47371-1322 |
| Mailing Address |
Po Box 1526 Lima OH 45802-1526 |
| Practice Telephone | 2607267131 |
| Mailing Telephone | 8664792711 |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2020-03-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
01066073 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200989190 | 05 | |
| IN | ANTHEM | 000000712370 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 411 W Tipton St, Seymour, IN 472742363 | 8125222349 |
| Street Address |
500 W VOTAW ST |
| City | PORTLAND |
| State | IN |
| Zip Code | 47371-1322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033115993 | Jay County Hospital | General Acute Care Hospital | 500 W Votaw St, Portland, IN 47371-1322 | 2005-06-24 |
| 1972074482 | Cassandra Louise Alexander | Social Worker | 500 W Votaw St, Portland, IN 47371-1322 | 2018-12-10 |
| 1669991279 | Indiana University Health Jay, Inc. | Medicare Defined Swing Bed Unit | 500 W Votaw St, Portland, IN 47371-1322 | 2017-09-14 |
| 1821517533 | Indiana University Health Jay, Inc. | Psychiatric Unit | 500 W Votaw St, Portland, IN 47371-1322 | 2017-09-13 |
| 1801315692 | Indiana University Health Jay, Inc. | General Acute Care Hospital | 500 W Votaw St, Portland, IN 47371-1322 | 2017-09-13 |
| 1871018119 | Matthew Sieg | Nurse Practitioner | 500 W Votaw St, Portland, IN 47371-1322 | 2017-08-08 |
| 1457803769 | Meridian Health Services Corp | Clinic/Center | 500 W Votaw St, Suite A, Portland, IN 47371-1322 | 2016-11-03 |
| 1336694736 | Anne Hardesty | Nurse Practitioner | 500 W Votaw St, Portland, IN 47371 | 2016-08-16 |
| 1952759557 | Jay County Hospital | Family Medicine | 500 W Votaw St, Suite A, Portland, IN 47371-1322 | 2016-05-25 |
| 1043672660 | Heather Ann Masters | Nurse Practitioner | 500 W Votaw St, Portland, IN 47371-1322 | 2016-03-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093365355 | Susan Hathaway | Technician | 3783 West 800 South, Portland, IN 47371 | 2019-09-18 |
| 1336643410 | Lisa Marcella Moore | Nurse Practitioner | 500 W. Votaw Street, Portland, IN 47371 | 2018-03-22 |
| 1609186030 | Carolyn Louise Keihn | Nurse Practitioner | 430 W. Votaw St., Portland, IN 47371 | 2010-10-19 |
| 1922125384 | Carla Ann Ford | Social Worker | 1758 W 100s, Jay County Hopsital Behavioral Health, Portland, IN 47371 | 2007-03-23 |
| 1902824956 | Midwest Healthstrategies, Inc | Physical Therapist | 1745 W 100 S, Portland, IN 47371 | 2006-07-18 |
| 1346212875 | Jenni Clear | Chiropractor | 603 N Meridian St, Portland, IN 47371 | 2006-02-07 |
| 1497756043 | Jay County Government | Ambulance | 902 N Creagor Ave, Portland, IN 47371 | 2005-08-04 |
| 1861574006 | Wal-mart Stores East, Lp | Technician/Technologist | 950 W Votaw St, Portland, IN 47371 | 2006-10-19 |
| 1982677241 | James P Clear | Chiropractor | 603 N Meridian St, Portland, IN 47371 | 2006-02-08 |
| 1982749867 | Family Practice of Jay County | Family Medicine | 428 West Votaw Street, Ste. A, Portland, IN 47371-0710 | 2007-02-20 |
| Find all providers in zip 47371 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528413754 | Bay Area Radiology, PC | Radiology | 2823 Ne 55th Ave, Portland, OR 97213-3439 | 2016-04-25 |
| 1790171585 | Dianna Howard | Radiology | 3181 Sw Sam Jackson Rd, Portland, OR 97239-3011 | 2015-04-08 |
| 1245674506 | Jaryd Yee | Radiology | Ohsu Radiology Department, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239-3011 | 2013-04-17 |
| 1700175874 | Ramsey Al-hakim | Radiology | 3181 Sw Sam Jackson Park Rd # L605, Portland, OR 97239-3011 | 2011-03-29 |
| 1386961712 | Yama Kharoti | Radiology | 2801 N Gantenbein Ave Ste 4239, Portland, OR 97227-1623 | 2010-04-25 |
| 1639313273 | David Pettersson | Radiology | Ohsu, 3181 Sw Sam Jackson Park Road, Portland, OR 97239 | 2009-04-27 |
| 1629276191 | Joe Mun-jung Chan | Radiology | 3181 Sw Sam Jackson Park Rd # L-340, Portland, OR 97239-3011 | 2007-07-06 |
| 1194846345 | Jay H Donohoo | Radiology | 01641 Sw Comus St, Portland, OR 97219-7858 | 2007-04-03 |
| 1851458046 | Summit Radiology Inc | Radiology | 1243 Sw Texas St, Portland, OR 97219-2046 | 2007-01-03 |
| 1376600064 | Jeffrey Terrance Hal | Radiology | 1926 W Burnside St, Unit 1604, Portland, OR 97209-2066 | 2007-01-02 |
| Find all providers in PORTLAND | ||||
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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.