PAVILION PEDIATRIC CENTER, LLC (NPI# 1063887438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063887438 |
| Entity Type | Organization |
| Organization Name | PAVILION PEDIATRIC CENTER, LLC |
| Practice Address |
2525 W University Ave Suite 404 Muncie IN 47303-3421 |
| Practice Telephone | 7652319494 |
| Practice Fax Number | 7655874456 |
| Mailing Telephone | 7652319494 |
| Mailing Fax Number | 7655874456 |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2016-04-04 |
| Authorized Official Name | DR. PRAKASH BHOOPALAM (OWNER) |
| Authorized Official Telephone | 7652319494 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 01040631A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201328850 | 05 | |
| IN | 100362560 | 05 | |
| IN | 201337310A | 05 |
| Street Address |
2525 W UNIVERSITY AVE SUITE 404 |
| City | MUNCIE |
| State | IN |
| Zip Code | 47303-3421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295739100 | Paul B Stewart | Surgery | 2525 W University Ave, Ste 403, Muncie, IN 47303-3409 | 2005-06-08 |
| 1043818396 | Jessica Lynn Handy | Registered Nurse | 2525 W University Ave, Muncie, IN 47303-3421 | 2020-10-09 |
| 1518502541 | Shelby Nicole Laflash | Nurse Practitioner | 2525 W University Ave, Muncie, IN 47303-3421 | 2019-11-13 |
| 1174164503 | Kasey L Ely | Nurse Practitioner | 2525 W University Ave, Muncie, IN 47303-3421 | 2019-10-07 |
| 1508390592 | Pavan K Patel | Internal Medicine | 2525 W University Ave, Suite 401, Muncie, IN 47303-3421 | 2017-04-17 |
| 1982138988 | Sudarsana Bharadwaj Srivangipuram | Student in an Organized Health Care Education/Training Program | 2525 W University Ave, Suite 401 Iu Health Ball Memorial Hospital, Muncie, IN 47303 | 2017-04-17 |
| 1639603947 | Akshita Patel | Internal Medicine | 2525 W University Ave, Suite 401, Muncie, IN 47303-3421 | 2017-04-13 |
| 1831622737 | Sindhu Priya Devarashetty | Student in an Organized Health Care Education/Training Program | 2525 W University Ave, Suite 401, Muncie, IN 47303-3421 | 2017-04-06 |
| 1053861500 | Rachel L Hency | Nurse Practitioner | 2525 W University Ave, Muncie, IN 47303-3421 | 2016-10-08 |
| 1841647260 | Richard Uy | Internal Medicine | 2525 W University Ave, Suite 401, Muncie, IN 47303-3421 | 2016-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144790726 | Elisabeth Marriah Bernal | Nurse Practitioner | 2525 W University Ave Suite 300, Muncie, IN 47303 | 2018-11-27 |
| 1013413806 | Charles Austin Curtis | Student in an Organized Health Care Education/Training Program | Iu Health Ball Memorial Family Medicine Residency, 221 North Celia Avenue, Muncie, IN 47303 | 2018-04-02 |
| 1730607359 | Ronald Settles | Home Health | 1812 Carver Dr, Muncie, IN 47303 | 2017-09-04 |
| 1932635034 | Abigail Chilsen | Student in an Organized Health Care Education/Training Program | 221 North Celia Avenue, Iu Health Ball Memorial Family Medicine Residency, Muncie, IN 47303 | 2017-05-10 |
| 1780117176 | Adil Khan | Internal Medicine | Iu Health Ball Memorial Hospital, 2525 W. University Ave, Suite 401, Muncie, IN 47303 | 2017-04-04 |
| 1508212044 | Erick Reece Christensen | Student in an Organized Health Care Education/Training Program | 2525 W University Ave Iu Health Ball Memorial Hospital, Suite 401, Muncie, IN 47303 | 2016-05-13 |
| 1700230075 | Mallory Nebergall | Student in an Organized Health Care Education/Training Program | 2525 W. University Ave. Ste 401, Iu Health Ball Memorial Hospital, Muncie, IN 47303 | 2016-04-22 |
| 1811341282 | Padmini Parameswaran | Student in an Organized Health Care Education/Training Program | 2525 W. University Ave, Suite 401, Muncie, IN 47303 | 2016-04-21 |
| 1437557345 | Great Lakes Family Dental Group-muncie, P.C. | Dentist | 1003 W. Mcgalliard Road, Muncie, IN 47303 | 2014-12-09 |
| 1194145185 | Swetha Boddeda | Student in an Organized Health Care Education/Training Program | 2401 W University Lane, Iu Health Ball Memorial Hospital, Muncie, IN 47303 | 2014-04-17 |
| Find all providers in zip 47303 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780992313 | Afshan Jabeen | Pediatrics | 2525 W University Ave Ste 404, Muncie, IN 47303 | 2010-09-16 |
| 1609840578 | Kirk D Perry | Pediatrics | 3807 S Madison St, Muncie, IN 47302-5758 | 2006-02-15 |
| 1922072511 | Donna Alford Wilkins | Pediatrics | Delaware County Health Department, 125 North Mulberry Street, Muncie, IN 47305-1718 | 2006-02-13 |
| 1235110503 | James R Byrn | Pediatrics | 205 N Tillotson Ave, Muncie, IN 47304-3900 | 2005-11-14 |
| 1154842813 | Fnu Sandhia | Pediatrics | 205 N Tillotson Ave, Muncie, IN 47304-3900 | 2017-07-03 |
| 1972999381 | Garg Pediatrics LLC | Pediatrics | 215 S Hutchinson Ave, Muncie, IN 47303-4774 | 2015-04-13 |
| 1629473053 | Meridian Health Services Corp | Pediatrics | 205 N Tillotson Ave, Muncie, IN 47304-3900 | 2014-10-28 |
| 1962782805 | Abdul Naseer Syed | Pediatrics | 205 N Tillotson Ave, Muncie, IN 47304-3900 | 2011-08-23 |
| 1871873711 | Bianca M Maya | Pediatrics | 205 N Tillotson Ave, Muncie, IN 47304-3900 | 2011-08-23 |
| 1568782373 | Indiana University Health Ball Memorial Physicians, Inc. | Pediatrics | 205 N Tillotson Ave, Suite 201b, Muncie, IN 47304-3996 | 2010-06-03 |
| Find all providers in MUNCIE | ||||
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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.