ATLANTIC SILVERSIDE EMERGENCY PHYSICIANS LLC (NPI# 1033507538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033507538 |
| Entity Type | Organization |
| Organization Name | ATLANTIC SILVERSIDE EMERGENCY PHYSICIANS LLC |
| Practice Address |
3630 Willowcreek Rd Portage IN 46368-5075 |
| Mailing Address |
13737 Noel Rd Ste 1600 Dallas TX 75240-1331 |
| Practice Telephone | 4694012386 |
| Mailing Telephone | 4694012386 |
| Mailing Fax Number | 2147122444 |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2015-01-06 |
| Authorized Official Name | EDDIE STONE (PRESIDENT) |
| Authorized Official Telephone | 4694012386 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | ATLANTIC SILVERSIDE EMERGENCY PHYSICIANS LLC | 6200 S Syracuse Way, Ste 200, Englewood, CO 80111 |
| Street Address |
3630 WILLOWCREEK RD |
| City | PORTAGE |
| State | IN |
| Zip Code | 46368-5075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720074701 | Muhammad Q. Choudry | Emergency Medicine | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2005-09-23 |
| 1396383881 | Jed Leifson | Registered Nurse | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2019-12-15 |
| 1508411315 | Chad Anthony Bogue | Nurse Practitioner | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2019-08-08 |
| 1366961757 | Cristina Lubash | Nurse Practitioner | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2017-09-17 |
| 1114468501 | Victoria Anne Pyke | Nurse Practitioner | 3630 Willowcreek Rd, Portage, IN 46368 | 2017-03-17 |
| 1336519685 | Heather Bolan | Speech-Language Pathologist | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2015-09-29 |
| 1346616646 | Porter Group Services, LLC | Hospitalist | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2015-08-20 |
| 1235546516 | Reuel Young Uy | Internal Medicine | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2014-07-17 |
| 1124452628 | Ranga Kota Md, PC | Internal Medicine | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2013-09-03 |
| 1891135620 | Kajal Patel Puranik | Family Medicine | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2013-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1831576693 | Bishara Robert Khoury | Family Medicine | 3545 Arbor Blvd Ste E, Portage, IN 46368 | 2015-04-30 |
| 1962813535 | Diane Farrington | Pharmacist | 6050 Us Hwy 6, Portage, IN 46368 | 2014-05-16 |
| 1588827562 | Jennifer Ann Rumpel | Allergy & Immunology | 6375 Us Highway 6 Ste C, Portage, IN 46368 | 2008-07-09 |
| 1588822688 | Total Renal Care Inc | Clinic/Center | 5823 Us Highway 6, Portage, IN 46368 | 2008-05-27 |
| 1235321480 | Michael Wendahl | Physical Therapist | 3691 Willowcreek Road, Suite 100, Portage, IN 46368 | 2007-08-13 |
| 1679663603 | Stephen V Headley | Family Medicine | 3283 Willowcreek Rd, Portage, IN 46368 | 2006-10-13 |
| 1730276486 | Robert Tan Ang | Psychiatry & Neurology | 3156 Willowcreek Road, Portage, IN 46368 | 2006-10-06 |
| 1013029883 | Primary Care PC | Family Medicine | 3125 Willowcreek Road, Portage, IN 46368 | 2006-08-31 |
| 1104936962 | Margaret Eileen Griffith | Dentist | 2646 Lois Street, Portage, IN 46368 | 2006-08-30 |
| Find all providers in zip 46368 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598185373 | Medexpress Urgent Care, PC - Michigan | Emergency Medicine | 6929 S Westnedge Ave, Portage, MI 49002-3550 | 2014-04-21 |
| 1902232473 | David F. Scullion | Emergency Medicine | 480 West Rd., Portage, ME 04768 | 2013-09-17 |
| 1174506307 | James T Gariti Sr. | Emergency Medicine | 2817 New Pinery Rd, Divine Savior Healthcare Inc, Portage, WI 53901-9257 | 2005-11-22 |
| 1720074701 | Muhammad Q. Choudry | Emergency Medicine | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2005-09-23 |
| 1639457740 | Robert S Redwood | Emergency Medicine | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2011-07-25 |
| 1083901342 | Francesca Rose Mcqueen | Emergency Medicine | 7901 Angling Rd, Portage, MI 49024-0714 | 2011-07-06 |
| 1912131699 | Marc D Biedermann | Emergency Medicine | 2817 New Pinery Rd, Portage, WI 53901 | 2009-05-08 |
| 1003066143 | John P Beavers | Emergency Medicine | 5717 Oakland Dr, Portage, MI 49024-1116 | 2008-09-25 |
| 1336315324 | Jennifer Marie Bahr | Emergency Medicine | 2817 New Pinery Rd, Divine Savior Healthcare, Inc., Portage, WI 53901-9240 | 2008-04-30 |
| 1649213554 | Michael M Bermudez | Emergency Medicine | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2006-06-14 |
| Find all providers in PORTAGE | ||||
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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.