DIAMOND MEDICAL GROUP


Address: 830 Park East Blvd, Lafayette, IN 47905-0778
Phone: 2194480369

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine Allopathic & Osteopathic Physicians

Other Data Sources

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

Office Location

Street Address 830 PARK EAST BLVD
City LAFAYETTE
State IN
Zip Code 47905-0778

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

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
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Competitor

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City LAFAYETTE
Zip Code 47905

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Dataset Information

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.

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