GAUTAM PHOOKAN (NPI# 1093750978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093750978 |
| Entity Type | Individual |
| Full Name | GAUTAM PHOOKAN |
| Credential | MD |
| Practice Address |
2525 W University Ave Suite 503 Muncie IN 47303-3421 |
| Mailing Address |
8333 Naab Rd Suite 250 Indianapolis IN 46260-5924 |
| Practice Telephone | 7652880441 |
| Practice Fax Number | 7652827879 |
| Mailing Telephone | 3173961300 |
| Mailing Fax Number | 3173961346 |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2013-11-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 1050143 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200206470A | 05 |
| Street Address |
2525 W UNIVERSITY AVE SUITE 503 |
| 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 |
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| 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 | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265759955 | Chih-ta Lin | Neurological Surgery | 2525 W University Ave Ste 503, Muncie, IN 47303-3409 | 2010-04-21 |
| 1942376926 | Indianapolis Neurosurgical Group | Neurological Surgery | 2525 W University Ave, Suite 503, Muncie, IN 47303-3421 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780146076 | T.s.shanks, Pllc | Neurological Surgery | 1919 State St Ste 250, New Albany, IN 47150-6805 | 2019-04-04 |
| 1326411158 | Stephen B Schroeder | Neurological Surgery | 2318 Turnberry Lane, Fort Wayne, IN 46804 | 2015-11-02 |
| 1326465725 | Hayder Jaffer | Neurological Surgery | 200 E 89th Ave Ste 3a, Merrillville, IN 46410-7319 | 2014-03-24 |
| 1083956015 | Us Medical & Business Consultants LLC | Neurological Surgery | 899 S College Mall Rd Ste 350, Bloomington, IN 47401-6301 | 2013-03-15 |
| 1659646917 | Shaheryar Faruq Ansari | Neurological Surgery | 8040 Clearvista Pkwy Ste 240, Indianapolis, IN 46256-4673 | 2012-03-19 |
| 1629367354 | Katrina Alise Ducis | Neurological Surgery | 705 Riley Hospital Dr Rm 1134, Indianapolis, IN 46202 | 2011-04-04 |
| 1639490857 | Karl Erach Balsara | Neurological Surgery | 705 Riley Hospital Dr # 1134, Indianapolis, IN 46202 | 2010-06-22 |
| 1093030322 | Gregory J Loomis | Neurological Surgery | 1024 Dress Ln, Evansville, IN 47725-9596 | 2010-03-30 |
| 1730317090 | Graham Charles Hall | Neurological Surgery | 1550 E County Line Rd Ste 201, Indianapolis, IN 46227-1082 | 2009-06-25 |
| 1003062332 | Fort Wayne Care Inc | Neurological Surgery | 347 W Berry St, Suite 216, Fort Wayne, IN 46802-2299 | 2008-08-18 |
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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.