BLOOMINGTON MEADOWS GP (NPI# 1033298120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033298120 |
Entity Type | Organization |
Organization Name | BLOOMINGTON MEADOWS GP |
Other Organization Name | BLOOMINGTON MEADOWS PHYSICIANS |
Practice Address |
3600 N Prow Rd Bloomington IN 47404-1616 |
Practice Telephone | 8123318000 |
Practice Fax Number | 8123318985 |
Mailing Telephone | 8123318000 |
Mailing Fax Number | 8123318985 |
Enumeration Date | 2006-11-02 |
Last Update Date | 2015-04-13 |
Authorized Official Name | STEVE FILTON (SR VP CFO) |
Authorized Official Telephone | 6107683300 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 364SP0813X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Geropsychiatric |
Physician Assistants & Advanced Practice Nursing Providers | ||
N | 364SP0807X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Child & Adolescent |
Physician Assistants & Advanced Practice Nursing Providers | ||
N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
324-1-PIP | IN | Allopathic & Osteopathic Physicians |
N | 283Q00000X | Psychiatric Hospital | 324-1-PIP | IN | Hospitals |
N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
28152858A | IN | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71000894A | IN | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | MAGELLAN | 060128000 | 01 |
IN | ANTHEM | 107936 | 01 |
IN | 200075480 | 05 | |
OH | OHIO MEDICAID | 2398043 | 01 |
Other Name | Type Code |
---|---|
Bloomington Meadows Physicians | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891796108 | Bloomington Meadows Gp | Psychiatric Hospital | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2005-08-09 |
Street Address |
3600 N PROW RD |
City | BLOOMINGTON |
State | IN |
Zip Code | 47404-1616 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891796108 | Bloomington Meadows Gp | Psychiatric Hospital | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2005-08-09 |
1558970517 | Randy Bargo | Nurse Practitioner | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2020-07-27 |
1396215786 | Hui Shi Serena Loh | Nurse Practitioner | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2018-11-28 |
1205287513 | Stephanie B. Pemberton | Nurse Practitioner | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2016-06-28 |
1124465729 | Ronda Rene Bray | Nurse Practitioner | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2013-05-23 |
1760555049 | Jennifer Bartlett Lorinsky-simpson | Counselor | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2006-11-16 |
1417968595 | Bloomington Meadows Gp - | Psychiatric Residential Treatment Facility | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2006-08-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013526631 | Sandra Clark | Counselor | 205 N College Avenue, Suite 210a, Bloomington, IN 47404 | 2020-07-29 |
1750926085 | Michelle Christine Dustin | Nurse Practitioner | 610 N Morton Street, Bloomigton, IN 47404 | 2019-11-11 |
1316440191 | Julie D'argent | Psychologist | 205 N College Ave Ste 430, Bloomington, IN 47404 | 2018-03-17 |
1770966467 | Richard Lawson | Counselor | 1117 North Jackson Street, Bloomington, IN 47404 | 2015-06-30 |
1477952109 | Teresa R. Foster | Social Worker | 205 N. College Avenue, Suite 210b, Bloomington, IN 47404 | 2014-08-19 |
1073879532 | First Health Plus, Inc | Clinic/Center | 104 North Curry Pike, Bloomington, IN 47404 | 2012-04-09 |
1497079982 | Tera Dee Nance | Counselor | 101 W. Kirkwood Avenue, Suite 009 Fountain Square Mall, Bloomington, IN 47404 | 2010-03-26 |
1962643114 | Pathways Counseling Center | Community/Behavioral Health | 3866 W. Third Street, Bloomington, IN 47404 | 2009-03-18 |
1932358595 | Catherine Elizabeth Batka | Psychologist | 101 W. Kirkwood Ave, Suite 103, Bloomington, IN 47404 | 2008-09-18 |
1396901005 | Kijin Woo | Dentist | 330 N Jacob Drive, Bloomington, IN 47404 | 2008-08-01 |
Find all providers in zip 47404 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578162509 | Mckenzie Mcadaragh | Nurse Practitioner | 10924 Girard Curve, Bloomington, MN 55431 | 2020-10-21 |
1609343128 | Katy Jo Northcutt | Nurse Practitioner | 1130 S Veterans Parkway, Bloomington, IL 61704-7117 | 2018-11-02 |
1255836813 | Erin Kathleen Sain | Nurse Practitioner | 326 W Woodcrest Drive, Bloomington, IN 47401 | 2018-03-27 |
1073061552 | David Wells | Nurse Practitioner | 8100 Northland Dr., Bloomington, MN 55431 | 2016-09-14 |
1720532005 | Antonia Jacqueline Abrahamsen | Nurse Practitioner | 2009 E Oakland Ave, Bloomington, IL 61701-5756 | 2016-08-04 |
1700229028 | Steve Mandieka | Nurse Practitioner | 10800 Lyndale Ave S Ste 114, Bloomington, MN 55420-2611 | 2013-04-17 |
1144538380 | Julie Ann Whelan | Nurse Practitioner | 8642 Wood Cliff Cir S, Bloomington, MN 55438-1514 | 2010-09-22 |
1386877413 | Carrie Hines | Nurse Practitioner | 4444 W State Road 46, Bloomington, IN 47404-9691 | 2009-08-24 |
1962634154 | Mark Stock | Nurse Practitioner | 9401 James Ave S Ste 162, Bloomington, MN 55431-2549 | 2009-08-20 |
1104911791 | Carla Mcgee | Nurse Practitioner | 600 North Jordan Avenue, Bloomington, IN 47405-3191 | 2006-10-03 |
Find all providers in BLOOMINGTON |
City | BLOOMINGTON |
Zip Code | 47404 |
Please comment or provide details below to improve the information on BLOOMINGTON MEADOWS GP.
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.