DR. MARLEY A GRIFFIN FAGG (NPI# 1811283005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1811283005 |
Entity Type | Individual |
Full Name | DR. MARLEY A GRIFFIN FAGG |
Other Name | DR. MARLEY A GRIFFIN |
Credential | DO |
Practice Address |
138 N Dixon Rd Kokomo IN 46901 |
Mailing Address |
10330 N Meridian St # 300 Indianapolis IN 46290-1024 |
Practice Telephone | 7652368282 |
Enumeration Date | 2011-06-26 |
Last Update Date | 2018-05-21 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207R00000X | Internal Medicine | 02004405A | IN | Allopathic & Osteopathic Physicians |
N | 207R00000X | Internal Medicine | 5101019418 | MI | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 201232310 | 05 |
Street Address |
138 N DIXON RD |
City | KOKOMO |
State | IN |
Zip Code | 46901 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437153145 | Melanie Lynn Bozard | Internal Medicine | 138 N Dixon Rd, Kokomo, IN 46901-4154 | 2005-06-09 |
1982237699 | Elizabeth Ann Fuller | Nurse Practitioner | 138 N Dixon Rd, Kokomo, IN 46901-4154 | 2020-02-20 |
1366002594 | Alexis Holt | Audiologist | 138 N Dixon Rd, Kokomo, IN 46901-4154 | 2019-06-19 |
1619473873 | Nathan Wheeler | Nurse Practitioner | 138 N Dixon Rd, Kokomo, IN 46901 | 2018-04-04 |
1376993543 | Breanna Lynn Lee | Nurse Practitioner | 138 N Dixon Rd, Kokomo, IN 46901-4154 | 2016-06-17 |
1730426958 | Sheryar Sarwar | Family Medicine | 138 N Dixon Rd, Kokomo, IN 46901-4154 | 2013-01-08 |
1356550057 | Michele B Weiberg | Internal Medicine | 138 N Dixon Rd, Kokomo, IN 46901-4154 | 2007-05-21 |
1447335898 | Christi L Redmon | Obstetrics & Gynecology | 138 N Dixon Rd, Kokomo, IN 46901 | 2006-10-26 |
1447217989 | Janice Elaine Morecraft | Nurse Practitioner | 138 N Dixon Rd, Kokomo, IN 46901-4154 | 2006-04-27 |
1891776951 | Victoria L Moyer | Family Medicine | 138 N Dixon Rd, Kokomo, IN 46901-4154 | 2005-11-07 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922607597 | Momentum Kokomo, LLC | Substance Abuse Rehabilitation Facility | 1236 N. Wabash Ave, Kokomo, IN 46901 | 2020-10-23 |
1457826869 | Jodi Gayle Lake | Developmental Therapist | 2523 Lorentson Ct, Kokomo, IN 46901 | 2018-10-11 |
1871088369 | Hope Behavioral Servies, LLC | Behavioral Analyst | 924 Clark St, Kokomo, IN 46901 | 2018-06-27 |
1255782306 | Forefront Dermatology, S.c. | Dermatology | 2130 W Sycamore St Ste 200, Kokomo, IN 46901 | 2016-06-29 |
1164860706 | Renee Michelle Brown | Registered Nurse | 2776 Amberwood Place, Kokomo, IN 46901 | 2013-06-05 |
1063642916 | Michelle K Rush | Speech-Language Pathologist | 2532 Lauren Ln, Kokomo, IN 46901 | 2009-07-24 |
1396957189 | Lifetime Dental Care of In, PC | Dentist | 927 S Washington St, Kokomo, IN 46901 | 2007-05-04 |
1245458355 | Wagoner Medical Center, LLC | Internal Medicine | 2016 W Sycamore, Kokomo, IN 46901 | 2007-04-23 |
1053442723 | Jesusa Salhieh | Contractor | Genesis Rehab Bloom, Kokomo, IN 46901 | 2007-03-07 |
1740382928 | Donald A Fantuzzo Dds PC | Dentist | 2196 W Sycamore St, Kokomo, IN 46901 | 2006-09-01 |
Find all providers in zip 46901 |
Taxonomy Code | 207R00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780882449 | Deshini A Moonesinghe | Internal Medicine | 3500 S Lafountain Street, Kokomo, IN 46902-3803 | 2007-07-04 |
1932300241 | Arun Agrawal | Internal Medicine | 3500 S. Lafountain Street, Kokomo, IN 46902-3803 | 2007-05-31 |
1245458355 | Wagoner Medical Center, LLC | Internal Medicine | 2016 W Sycamore, Kokomo, IN 46901 | 2007-04-23 |
1811061120 | Carl Edwin Kuenzli | Internal Medicine | 3492 Candy Ln, Kokomo, IN 46902-4412 | 2006-11-20 |
1073542940 | Julie B Tredemeyer | Internal Medicine | 3611 S Reed Rd Ste 103, Kokomo, IN 46902-3828 | 2006-07-02 |
1407817109 | James M Scheffler | Internal Medicine | 2030 W Boulevard, Kokomo, IN 46902-6079 | 2006-03-31 |
1912978776 | Dustardie D Reed | Internal Medicine | 3900 Southland Ave, Kokomo, IN 46902 | 2006-01-30 |
1891776779 | Chris Bahler | Internal Medicine | 1907 W Sycamore St Fl 3, Kokomo, IN 46901 | 2005-11-08 |
1740280015 | Baikadi A Ravindra IIi | Internal Medicine | 3505 S Reed Rd, Kokomo, IN 46902-3838 | 2005-07-28 |
1700882701 | Gerald Kevin Greer | Internal Medicine | 2401 Columbus Blvd, Kokomo, IN 46901-6455 | 2005-06-23 |
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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.