ELLEN FAN (NPI# 1871797134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871797134 |
| Entity Type | Individual |
| Full Name | ELLEN FAN |
| Credential | MD |
| Practice Address |
3840 N Sherman Dr Indianapolis IN 46226-4462 |
| Mailing Address |
8910 Purdue Rd Ste.500 Indianapolis IN 46268-6100 |
| Practice Telephone | 3175413400 |
| Practice Fax Number | 3175413444 |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2011-07-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 01063338A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200876690 | 05 | |
| IN | ANTHEM | 000000541927 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730206566 | Ellen Fan | Pharmacist | 95 Old Short Hills Rd, West Orange, NJ 07052-1008 | 2007-03-25 |
| 1134153646 | Ellen Fan | Psychiatry & Neurology | 3308 Preston Rd, Suite 350 Box 242, Plano, TX 75093-7453 | 2006-07-10 |
| Street Address |
3840 N SHERMAN DR |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46226-4462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417914441 | Laurie A Goebel | Pediatrics | 3840 N Sherman Dr, Indianapolis, IN 46226-4462 | 2006-04-26 |
| 1164915310 | Mariah Ann Adams | Dietitian, Registered | 3840 N Sherman Dr, Indianapolis, IN 46226-4462 | 2018-06-12 |
| 1669751491 | Becky J Sayre | Counselor | 3840 N Sherman Dr, Indianapolis, IN 46226-4462 | 2011-08-10 |
| 1124330832 | Natalie Ann Smith | Dietitian, Registered | 3840 N Sherman Dr, Indianapolis, IN 46226-4462 | 2010-07-10 |
| 1245464841 | Janet Valencia-lopez | Case Manager/Care Coordinator | 3840 N Sherman Dr, Indianapolis, IN 46226-4462 | 2009-05-11 |
| 1861663494 | Patryce Jeanale Moore | Case Manager/Care Coordinator | 3840 N Sherman Dr, Indianapolis, IN 46226-4462 | 2008-03-24 |
| 1962673400 | Diana Collins | Case Manager/Care Coordinator | 3840 N Sherman Dr, Indianapolis, IN 46226-4462 | 2008-03-12 |
| 1326218850 | Marie Sanders | Case Manager/Care Coordinator | 3840 N Sherman Dr, Forest Manor Health Care, Indianapolis, IN 46226-4462 | 2008-03-12 |
| 1144490392 | Health and Hospital Corporation of Marion County | General Acute Care Hospital | 3840 N Sherman Dr, Indianapolis, IN 46226-4462 | 2008-03-04 |
| 1093870867 | Brian T Walborn | Optometrist | 3840 N Sherman Dr, Eskenazi Health Center Forest Mano, Indianapolis, IN 46226-4462 | 2006-12-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053771972 | Iman Emami Ghafari | Chiropractor | 4082 Pendelton Way, Indianapolis, IN 46226 | 2016-03-04 |
| 1649649039 | Tindley Accelerated Schools | Local Education Agency (LEA) | 4625 Arlington Avenue, Indianapolis, IN 46226 | 2015-09-16 |
| 1801146261 | Strength Renewed Counseling Services | Social Worker | 5660 Caito Drive, Suite 122, Indianapolis, IN 46226 | 2012-09-13 |
| 1114122447 | Monica Beasley | Nurse's Aide | 835 Belhaven Place Apt. #3, Indianapolis, IN 46226 | 2007-06-18 |
| 1558413682 | Denise Lynne Schnell | Nurse Practitioner | 5259 N David Street, Laurence Community Wellness Center, Indianapolis, IN 46226 | 2007-01-17 |
| 1245326792 | Lina R Ealy | Specialist | 5856 Cedarstone Court, Indianapolis, IN 46226 | 2006-10-04 |
| 1740373323 | Options Treatment Acquisition Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 5602 Caito Drive, Indianapolis, IN 46226 | 2006-10-02 |
| 1518064823 | Hook Superx LLC | Durable Medical Equipment & Medical Supplies | 6975 North Pendleton Pike, Indianapolis, IN 46226 | 2006-09-20 |
| 1740383454 | Hook Superx LLC | Durable Medical Equipment & Medical Supplies | 5005 E 56th St, Indianapolis, IN 46226 | 2006-09-07 |
| 1205964186 | Karl Lee Manders | Specialist | 5845 High Fall Rd, Indianapolis, IN 46226-1017 | 2007-03-01 |
| Find all providers in zip 46226 | ||||
| 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 |
|---|---|---|---|---|
| 1073125225 | Relymd Medical Group In, LLC | Family Medicine | 9221 Crawfordsville Rd, Indianapolis, IN 46234-1521 | 2020-08-19 |
| 1134765993 | Basil Vareldzis | Family Medicine | 9125 Nautical Watch Dr, Indianapolis, IN 46236-9036 | 2019-11-26 |
| 1366084329 | Rebekah Venable | Family Medicine | 5455 W 86th St Ste 210, Indianapolis, IN 46268-1530 | 2019-10-11 |
| 1710455738 | Physicians Wellness Associates LLC | Family Medicine | 4735 Statesmen Drive, Suite C, Indianapolis, IN 46250 | 2018-11-07 |
| 1386150043 | Brengle Family Medicine | Family Medicine | 8803 N Meridian St Ste 350, Indianapolis, IN 46260-5386 | 2017-12-18 |
| 1164937249 | Amy Cheung | Family Medicine | 6484 N Chester Ave, Indianapolis, IN 46220-4422 | 2017-12-11 |
| 1578017182 | Medical Specialty LLC | Family Medicine | 2301 N Meridian St, Indianapolis, IN 46208-5729 | 2016-08-11 |
| 1245685742 | Christopher Basom | Family Medicine | 8501 E 56th St Ste 120, Indianapolis, IN 46216-2118 | 2016-05-03 |
| 1760846877 | Catherine Gambale Trigonis | Family Medicine | 404 E Washington St Ste A, Indianapolis, IN 46204 | 2016-04-06 |
| 1205204203 | Community Health Network | Family Medicine | 1643 E Hanna Ave, Ste 108, Indianapolis, IN 46227-3655 | 2015-09-08 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46226 |
Please comment or provide details below to improve the information on ELLEN FAN.
| 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.