KIMBERLY GANGWER (NPI# 1063871770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063871770 |
Entity Type | Individual |
Full Name | KIMBERLY GANGWER |
Practice Address |
5177 Mccarty Ln Lafayette IN 47905-8764 |
Mailing Address |
Po Box 5545 Lafayette IN 47903-5545 |
Practice Telephone | 7654488000 |
Mailing Telephone | 7654488000 |
Enumeration Date | 2016-02-23 |
Last Update Date | 2016-03-30 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
CERT 92231 | IN | Technologists, Technicians & Other Technical Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | ANTHEM PROVIDER NUMBER | 000000996847 | 01 |
Street Address |
5177 MCCARTY LN |
City | LAFAYETTE |
State | IN |
Zip Code | 47905-8764 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659551224 | Shellene Coleman | Nurse Practitioner | 5177 Mccarty Ln, Lafayette, IN 47905-8764 | 2007-11-12 |
1558989491 | Nuvair Ali Imam | Student in an Organized Health Care Education/Training Program | 5177 Mccarty Ln, Lafayette, IN 47905-8764 | 2020-07-07 |
1336766559 | Jasmin Poonia | Student in an Organized Health Care Education/Training Program | 5177 Mccarty Ln, Lafayette, IN 47905-8764 | 2020-07-03 |
1316564537 | Meagan Dineen | Student in an Organized Health Care Education/Training Program | 5177 Mccarty Ln, Lafayette, IN 47905-8764 | 2020-07-03 |
1952927469 | Manjinder Singh Sekhon | Student in an Organized Health Care Education/Training Program | 5177 Mccarty Ln, Lafayette, IN 47905-8764 | 2020-06-20 |
1083236046 | Brittany Chana'is Kendrick | Midwife | 5177 Mccarty Ln, Lafayette, IN 47905-8764 | 2020-05-13 |
1629607239 | Sherif Magdy Amin | Student in an Organized Health Care Education/Training Program | 5177 Mccarty Ln, Lafayette, IN 47905-8764 | 2020-04-06 |
1710516406 | Victoria Claire Robinson | Specialist/Technologist, Other | 5177 Mccarty Ln, Lafayette, IN 47905-8764 | 2020-04-03 |
1871153825 | Vinusiya Shanmugalingam | Student in an Organized Health Care Education/Training Program | 5177 Mccarty Ln, Lafayette, IN 47905-8764 | 2019-06-20 |
1588223267 | Raeven N Cole | Registered Nurse | 5177 Mccarty Ln, Lafayette, IN 47905-8764 | 2019-06-06 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538719893 | Elements Counseling LLC | Social Worker | 115 N. Farabee Drive, Lafayette, IN 47905 | 2019-09-18 |
1134596869 | Indiana Dental Sleep Therapy LLC | Dentist | 4921 Sr 26 E, Suite 300, Lafayette, IN 47905 | 2015-08-28 |
1255750899 | Emily S Miller | Physical Therapist | 1701 Creasy Ln, Lafayette, IN 47905 | 2014-04-10 |
1073876215 | Nathan Webster | Dentist | 1530 Kossuth St., Lafayette, IN 47905 | 2012-06-22 |
1578848370 | Mark Jin Kim | Pharmacist | 1801 South St., Lafayette, IN 47905 | 2011-10-13 |
1700177185 | Shannon Tawn Harris | Speech-Language Pathologist | 8900 Cobbler Lane, Lafayette, IN 47905 | 2011-04-20 |
1508164484 | David Thomas Beine | Specialist/Technologist | 1321 Unity Pl Ste A, Lafayette, IN 47905 | 2011-03-02 |
1447569538 | Deidre Dudley | Nurse Practitioner | 1701 S Creasy Ln Ste 1w93, Lafayette, IN 47905 | 2010-10-07 |
1548493067 | Unity Healthcare, LLC | Podiatrist | 750 Park East Blvd, Unit 4, Lafayette, IN 47905 | 2009-09-01 |
1073762969 | Lynette Marie Alexander | Nurse Practitioner | 5500 St Rd. 38 East, Lafayette, IN 47905 | 2008-09-16 |
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Taxonomy Code | 246ZC0007X |
Grouping | Technologists, Technicians & Other Technical Service Providers |
Classification | Specialist/Technologist, Other |
Specialization | Surgical Assistant |
A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training. |
Notes: Source: Association of Surgical Assistants, 2014. [7/1/2014: title modified, definition modified] http://www.surgicalassistant.org/index.php/surgical-assisting Additional Resources: National Surgical Assistant Association, www.nsaa.net. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710516406 | Victoria Claire Robinson | Specialist/Technologist, Other | 5177 Mccarty Ln, Lafayette, IN 47905-8764 | 2020-04-03 |
1720569569 | Dastgeer Surgical Associates | Specialist/Technologist, Other | 200 Exempla Cir, Lafayette, CO 80026-3370 | 2018-08-28 |
1366968562 | Nichole E. Tolle | Specialist/Technologist, Other | 3750 Landmark Dr Ste B, Lafayette, IN 47905-6652 | 2017-08-18 |
1740641190 | Shelly Blocher | Specialist/Technologist, Other | 1345 Unity Pl, Ste 210, Lafayette, IN 47905-5760 | 2016-03-14 |
1720447923 | Ginger Duplantis | Specialist/Technologist, Other | 917 Coolidge Blvd, Lafayette, LA 70503-2433 | 2016-02-16 |
1902074552 | Anne Hunter | Specialist/Technologist, Other | 2600 Ferry St, Indianapolis Neurosurgical Group, Lafayette, IN 47904-3055 | 2008-02-18 |
1306014949 | Kimberly L Fleischhauer | Specialist/Technologist, Other | 2600 Ferry St, Lafayette, IN 47904-3055 | 2008-02-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932750056 | Brazzale Surgical Assisting LLC | Specialist/Technologist, Other | 1911 Huppenthal Dr, Schererville, IN 46375-3008 | 2019-09-20 |
1043868839 | Danielle Rekitzke | Specialist/Technologist, Other | 745 Hiawatha Ct, Lowell, IN 46356-1631 | 2019-08-27 |
1104392208 | Hassan Hanna | Specialist/Technologist, Other | 375 Kingsmill Dr, Chesterton, IN 46304-2266 | 2018-10-17 |
1568992055 | Ariel Patricia Brazzale | Specialist/Technologist, Other | 4936 Pheasant Ct, Schererville, IN 46375-3384 | 2017-06-15 |
1295275337 | Kristin Curtis | Specialist/Technologist, Other | 103 Taylors Way, North Liberty, IN 46554-9223 | 2017-03-07 |
1821536574 | Craig Cole | Specialist/Technologist, Other | 901 Somerset Ct, Sellersburg, IN 47172-2811 | 2017-02-02 |
1275075137 | Dusko Mirjanic | Specialist/Technologist, Other | 133 Holly Ln, Schererville, IN 46375-1177 | 2016-11-09 |
1447709118 | Christina L. Hope | Specialist/Technologist, Other | 8141 S Emerson Ave Suite A, Indianapolis, IN 46237-8560 | 2016-09-23 |
1811376494 | Jeremy Ingram | Specialist/Technologist, Other | 1806 Bono Rd Apt 16, New Albany, IN 47150-4680 | 2015-05-28 |
1861800195 | Audie Williams | Specialist/Technologist, Other | 438 W Clearwater Dr, Warsaw, IN 46582-7769 | 2014-07-30 |
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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.