Ashley B Obannon (NPI# 1629248711, PAC ID# 3870644982) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PATHOLOGY.
| Nation Provider ID (NPI) | 1629248711 |
| PAC ID by PECOS | 3870644982 |
| Professional Enrollment ID | I20120530000165 |
| Full Name | Ashley B Obannon |
| Organization Legal Name | MICHIANA GASTROENTEROLOGY, INC |
| Address |
53830 Generations Dr South Bend IN 46635-1557 |
| Phone Number | 5742340049 |
| Gender | F |
| Medical School | UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE |
| Graduation Year | 2003 |
| Primary Specialty | PATHOLOGY |
| Group Practice PAC ID | 2163529892 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150006 | LA PORTE HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 102 E Culver Rd, Knox, IN 46534-2216 | 5747721137 | PATHOLOGY ASSOCIATES OF NORTHWEST INDIANA INC |
| 1007 Lincolnway, La Porte, IN 46350-3201 | 2193262307 | PATHOLOGY ASSOCIATES OF NORTHWEST INDIANA INC |
| 53830 Generations Dr, South Bend, IN 46635-1557 | 5742340049 | MICHIANA GASTROENTEROLOGY, INC |
| Organization Legal Name | MICHIANA GASTROENTEROLOGY, INC |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Seth Fredric Tatel | Gastroenterology | Michiana Gastroenterology, Inc | 17501 Generations Dr, South Bend, IN 46635-1589 |
| Sonali Shukla | Pathology | Michiana Gastroenterology, Inc | 53830 Generations Dr, South Bend, IN 46635-1557 |
| Pankaj A Patel | Internal Medicine | Michiana Gastroenterology, Inc | 1919 Lake Ave, Suite 107, Plymouth, IN 46563-7830 |
| Lisa A Ostrowski | Pathology | Michiana Gastroenterology, Inc | 53830 Generations Dr, South Bend, IN 46635-1557 |
| John G Mathis | Internal Medicine | Michiana Gastroenterology, Inc | 1919 Lake Ave, Suite 107, Plymouth, IN 46563-7830 |
| Oliver D Gilliam | Internal Medicine | Michiana Gastroenterology, Inc | 1919 Lake Ave, Suite 107, Plymouth, IN 46563-7830 |
| Thomas R Vanderheyden Jr. | Internal Medicine | Michiana Gastroenterology, Inc | 1919 Lake Ave, Suite 107, Plymouth, IN 46563-7830 |
| Desiree D Williams | Nurse Practitioner | Michiana Gastroenterology, Inc | 1919 Lake Ave, Suite 107, Plymouth, IN 46563-7830 |
| Michael A Manbeck | Internal Medicine | Michiana Gastroenterology, Inc | 1919 Lake Ave, Suite 107, Plymouth, IN 46563-7830 |
| Ravi J Patel | Internal Medicine | Michiana Gastroenterology, Inc | 17501 Generations Dr, South Bend, IN 46635-1589 |
| Street Address |
53830 GENERATIONS DR |
| City | SOUTH BEND |
| State | IN |
| Zip | 46635-1557 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sonali Shukla | Pathology | Michiana Gastroenterology, Inc | 53830 Generations Dr, South Bend, IN 46635-1557 |
| Jamie A Davidson | Certified Registered Nurse Anesthetist (crna) | Mg Anesthesia LLC | 53830 Generations Dr, South Bend, IN 46635-1557 |
| Lisa A Ostrowski | Pathology | Michiana Gastroenterology, Inc | 53830 Generations Dr, South Bend, IN 46635-1557 |
| Jonathan Skrabak | Certified Registered Nurse Anesthetist (crna) | Mg Anesthesia LLC | 53830 Generations Dr, South Bend, IN 46635-1557 |
| Janet S Vardaman | Certified Registered Nurse Anesthetist (crna) | Mg Anesthesia LLC | 53830 Generations Dr, South Bend, IN 46635-1557 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael James Oconnell | Family Medicine | 17960 Cleveland Rd, South Bend, IN 46635-1349 | |
| Auna L Preston | Psychologist, Clinical | Samaritan Family Health and Counseling Center, Inc. | 17195 Cleveland Rd, South Bend, IN 46635-1415 |
| Keith Munneke | Clinical Social Worker | Samaritan Family Health and Counseling Center, Inc. | 17195 Cleveland Rd, South Bend, IN 46635-1415 |
| Karen M Zusman | Occupational Therapy | Allied Physicians of Michiana, LLC | 6301 University Commons, Suite 430, South Bend, IN 46635-1416 |
| Sheryl A Vanheesbeke | Physical Therapy | Allied Physicians of Michiana, LLC | 6301 University Commons, South Bend, IN 46635-1416 |
| Thomas James Mango | Orthopedic Surgery | Allied Physicians of Michiana, LLC | 6301 University Commons, Suite 100, South Bend, IN 46635-1416 |
| Peter Damien Miller | Interventional Radiology | Northern Indiana Magnetic Resonance Center, LLP | 17333 Dugdale Dr, South Bend, IN 46635-1500 |
| Matthew Richard Gillott | Diagnostic Radiology | Northern Indiana Magnetic Resonance Center, LLP | 17333 Dugdale Dr, South Bend, IN 46635-1500 |
| Ester Petronella J Van Der Wal | Diagnostic Radiology | Northern Indiana Magnetic Resonance Center, LLP | 17333 Dugdale Dr, South Bend, IN 46635-1500 |
| Lyndsay Alexandra Oancea | Interventional Radiology | Northern Indiana Magnetic Resonance Center, LLP | 17333 Dugdale Dr, South Bend, IN 46635-1500 |
| Find all physicians in zip 46635 | |||
| City | SOUTH BEND |
| Zip Code | 46635 |
| Specialty | PATHOLOGY |
| City + Specialty | SOUTH BEND + PATHOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.