DIAMOND MEDICAL GROUP (NPI# 1790297935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790297935 |
Entity Type | Organization |
Organization Name | DIAMOND MEDICAL GROUP |
Practice Address |
830 Park East Blvd Lafayette IN 47905-0778 |
Mailing Address |
3679 Wakefield Dr West Lafayette IN 47906-8708 |
Practice Telephone | 2194480369 |
Mailing Telephone | 2194480369 |
Enumeration Date | 2017-10-27 |
Last Update Date | 2018-02-14 |
Authorized Official Name | BENERJI GUDAPATI (OWNER) |
Authorized Official Telephone | 2194480369 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
Entity Type | Entity Name | Entity Address |
---|---|---|
Indiana Business Entities | DIAMOND MEDICAL GROUP LLC | 3679 Wakefield Drive, West Lafayette, IN 47906 |
System for Award Management (SAM) Entities | DIAMOND MEDICAL GROUP, LLC | 1340 Poydras St. Ste. 1870, New Orleans, LA 70112-5200 |
New York State Corporations | DIAMOND MEDICAL GROUP, P.C. | 1488 Wantagh Avenue, Wantagh, New York 11793 |
Street Address |
830 PARK EAST BLVD |
City | LAFAYETTE |
State | IN |
Zip Code | 47905-0778 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538719893 | Elements Counseling LLC | Social Worker | 115 N. Farabee Drive, Lafayette, IN 47905 | 2019-09-18 |
1134596869 | Indiana Dental Sleep Therapy LLC | Dentist | 4921 Sr 26 E, Suite 300, Lafayette, IN 47905 | 2015-08-28 |
1255750899 | Emily S Miller | Physical Therapist | 1701 Creasy Ln, Lafayette, IN 47905 | 2014-04-10 |
1073876215 | Nathan Webster | Dentist | 1530 Kossuth St., Lafayette, IN 47905 | 2012-06-22 |
1578848370 | Mark Jin Kim | Pharmacist | 1801 South St., Lafayette, IN 47905 | 2011-10-13 |
1700177185 | Shannon Tawn Harris | Speech-Language Pathologist | 8900 Cobbler Lane, Lafayette, IN 47905 | 2011-04-20 |
1508164484 | David Thomas Beine | Specialist/Technologist | 1321 Unity Pl Ste A, Lafayette, IN 47905 | 2011-03-02 |
1447569538 | Deidre Dudley | Nurse Practitioner | 1701 S Creasy Ln Ste 1w93, Lafayette, IN 47905 | 2010-10-07 |
1548493067 | Unity Healthcare, LLC | Podiatrist | 750 Park East Blvd, Unit 4, Lafayette, IN 47905 | 2009-09-01 |
1073762969 | Lynette Marie Alexander | Nurse Practitioner | 5500 St Rd. 38 East, Lafayette, IN 47905 | 2008-09-16 |
Find all providers in zip 47905 |
Taxonomy Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568060135 | Audubon Family Medicine LLC | Family Medicine | 2301 Moss St, Lafayette, LA 70501-2125 | 2020-10-15 |
1871116244 | Partners In Primary Care La PC | Family Medicine | 537 Bertrand Dr Ste F0a, Lafayette, LA 70506-5556 | 2020-05-20 |
1013471259 | Courtney Cobb | Family Medicine | 500 Juliette Pl, Lafayette, LA 70506-4571 | 2019-01-22 |
1538672993 | Pamela Rene Roeder | Family Medicine | 8196 N 1000 E, Lafayette, IN 47905-9742 | 2017-11-08 |
1780114074 | Mimi Nguyen | Family Medicine | 4212 W Congress St Ste 1600, Lafayette, LA 70506-6767 | 2017-06-19 |
1679922249 | Lafayette Health Ventures, Inc | Family Medicine | 917 W Gloria Switch Road, Lafayette, LA 70507-2309 | 2016-06-06 |
1003278854 | Rebecca Lynn Currier Curran | Family Medicine | 2932 Ambassador Caffery Parkway, Lafayette, LA 70506 | 2016-03-22 |
1871989244 | Justin Matthew Pratt | Family Medicine | 1630 Rue Du Belier Apt 1307, Lafayette, LA 70506 | 2015-04-12 |
1558761973 | A. Elaine Ashby, M.d., Inc. | Family Medicine | 3732 Mt Diablo Blvd Ste 385, Lafayette, CA 94549-3625 | 2014-09-04 |
1538402573 | Premier Urgent Care | Family Medicine | 307 Alcide Dominique Dr, Lafayette, LA 70506-1052 | 2013-03-28 |
Find all providers in LAFAYETTE |
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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.