DR. WILLIS W STEVENSON III (NPI# 1780736645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780736645 |
Entity Type | Individual |
Full Name | DR. WILLIS W STEVENSON III |
Credential | MD |
Practice Address |
2310 California Road Elkhart IN 46514-1228 |
Practice Telephone | 5742644163 |
Practice Fax Number | 5742629650 |
Mailing Telephone | 5742644163 |
Mailing Fax Number | 5742629650 |
Enumeration Date | 2007-01-18 |
Last Update Date | 2010-11-18 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
01062348A | IN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | MEDICAL LICENSE | 01062348A | 01 |
IN | FEDERAL DEA | BS9950999 | 01 |
IN | 200847880 | 05 |
Street Address |
2310 CALIFORNIA ROAD |
City | ELKHART |
State | IN |
Zip Code | 46514-1228 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740215326 | Denise Friedli | Physical Therapist | 2310 California Road, Suite A, Elkhart, IN 46514-1228 | 2006-07-11 |
1366645178 | Jonathan D Schrock | Anesthesiology | 2310 California Road, Elkhart, IN 46514-1228 | 2007-06-08 |
1396951117 | John Mark Schramm | Orthopaedic Surgery | 2310 California Road, Elkhart, IN 46514-1228 | 2007-05-16 |
1528179199 | Michelle R Martin | Physical Therapist | 2310 California Road, Elkhart, IN 46514-1228 | 2006-08-31 |
1588775779 | Phillip J Rice | Nurse Anesthetist, Certified Registered | 2310 California Road, Suite A, Elkhart, IN 46514-1228 | 2006-08-31 |
1285645903 | Gene W Grove | Anesthesiology | 2310 California Road, Elkhart, IN 46514-1228 | 2006-08-10 |
1023029741 | Jason J Hix | Family Medicine | 2310 California Road, Elkhart, IN 46514-1228 | 2006-08-10 |
1174534895 | David A Beatty | Anesthesiology | 2310 California Road, Elkhart, IN 46514-1228 | 2006-08-10 |
1205844214 | Pamela Lynn Pfail | Specialist/Technologist | 2310 California Road, Elkhart, IN 46514-1228 | 2006-08-04 |
1053325589 | Mark A Klaassen | Orthopaedic Surgery | 2310 California Road, Ste A, Elkhart, IN 46514-1228 | 2006-07-28 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891333522 | Adam Collier | Nurse Anesthetist, Certified Registered | 600 Elkhart Boulvard, Elkhart, IN 46514 | 2019-12-12 |
1861034688 | Heart City Health Center, Inc. | Obstetrics & Gynecology | 1545 Cassopolis Street, Elkhart, IN 46514 | 2019-10-14 |
1982263398 | Fresenius Medical Care North Elkhart, LLC | Clinic/Center | 801 W Bristol St, Elkhart, IN 46514 | 2019-06-10 |
1487118220 | Hellenic Senior Living of Elkhart, LLC | Assisted Living Facility | 2528 Bypass Road, Elkhart, IN 46514 | 2019-01-25 |
1922595792 | Anna Cornelia Smith | Nutritionist | 51803 Tall Pines Dr, Elkhart, IN 46514 | 2018-04-17 |
1114438496 | Erika Lynn Farrell | Counselor | 3120 Suite B Windsor Court, Elkhart, IN 46514 | 2017-10-13 |
1740728948 | Michael Scheretie | Nurse Anesthetist, Certified Registered | 52866 Wildflower Ln, Elkhart, IN 46514 | 2017-02-08 |
1821355876 | Marcy Lynn Adams | Nurse Practitioner | 1104 W Bristol St, Elkhart, IN 46514 | 2012-04-16 |
1053694265 | Paul A. Price | Pharmacist | 1400 Cassopolis St., Elkhart, IN 46514 | 2011-09-23 |
1528362647 | Beacon Medical Group, Inc. | Internal Medicine | 500 Arcade Ave., Suite 400, Elkhart, IN 46514 | 2011-01-04 |
Find all providers in zip 46514 |
Taxonomy Code | 207XX0005X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Orthopaedic Surgery |
Specialization | Sports Medicine |
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235404526 | Eric Philip Tannenbaum | Orthopaedic Surgery | 940 N Marr Rd Ste C, Columbus, IN 47201 | 2012-03-20 |
1326213109 | Steven K Ahlfeld Md, PC | Orthopaedic Surgery | 9302 N Meridian St Ste 110, Indianapolis, IN 46260-1818 | 2008-04-23 |
1780707265 | New Hope Orthopaedics and Sports Medicine PC | Orthopaedic Surgery | 325 Westfield Rd, Suite A, Noblesville, IN 46060-1497 | 2007-04-09 |
1740313071 | Atlas Orthopedics & Sports Medicine Inc PC | Orthopaedic Surgery | 3660 Guion Rd Ste 230, Indianapolis, IN 46222-1691 | 2007-03-14 |
1780723122 | Jeffrey S Staron | Orthopaedic Surgery | 8141 Calumet Ave Unit 1, Munster, IN 46321-1701 | 2007-02-05 |
1376622936 | Lorin Merrill Brown | Orthopaedic Surgery | 1950 45th St Ste 200, Munster, IN 46321-3958 | 2006-11-03 |
1033214366 | Rivercross Orthopaedics & Sports Medicine PC | Orthopaedic Surgery | 18051 River Ave Ste 100, Noblesville, IN 46062-7093 | 2006-09-13 |
1366489338 | Dale S Snead | Orthopaedic Surgery | 201 Pennsylvania Parkway Suite 200, Indianapolis, IN 46280-2301 | 2006-05-31 |
1407859051 | Daniel C Eby | Orthopaedic Surgery | 600 W. 13th St, Suite 200, Jasper, IN 47546-1883 | 2005-05-27 |
1639782907 | Jenna Renee Sparks | Orthopaedic Surgery | 1801 N Senate Blvd Ste 400, Indianapolis, IN 46202-1245 | 2020-08-26 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on DR. WILLIS W STEVENSON III.
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.