INDIANA PHYSICIAN MANAGEMENT-RANDOLPH, LLC (NPI# 1104102037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104102037 |
| Entity Type | Organization |
| Organization Name | INDIANA PHYSICIAN MANAGEMENT-RANDOLPH, LLC |
| Practice Address |
473 E Greenville Ave Winchester IN 47394-9436 |
| Mailing Address |
7148 Solution Ctr Chicago IL 60677-7001 |
| Practice Telephone | 3178700480 |
| Practice Fax Number | 3178700499 |
| Mailing Telephone | 3178706763 |
| Mailing Fax Number | 3178700499 |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2013-01-11 |
| Authorized Official Name | STEWART BICK (PRESIDENT) |
| Authorized Official Telephone | 3173385053 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201037180B | 05 |
| Street Address |
473 E GREENVILLE AVE |
| City | WINCHESTER |
| State | IN |
| Zip Code | 47394-9436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457359937 | Samuel D Krutz | Anesthesiology | 473 E Greenville Ave, Winchester, IN 47394-9436 | 2005-07-08 |
| 1689039604 | Justin Hersberger | Specialist/Technologist | 473 E Greenville Ave, Winchester, IN 47394-9436 | 2015-12-17 |
| 1184031932 | Pauletta J Hummel | Nurse Practitioner | 473 E Greenville Ave, Winchester, IN 47394 | 2014-07-14 |
| 1265860639 | Indiana Emergency Physicians, LLP | Emergency Medicine | 473 E Greenville Ave, Winchester, IN 47394-9436 | 2013-10-23 |
| 1033304241 | St. Vincent Randolph Hospital, Inc. | Family Medicine | 473 E Greenville Ave, Winchester, IN 47394-9436 | 2007-09-11 |
| 1477760205 | Mary Ellen Jackson | Dietitian, Registered | 473 E Greenville Ave, Winchester, IN 47394-9436 | 2007-05-17 |
| 1558581181 | Kathryn A Wren I | Pharmacist | 473 E Greenville Ave, Winchester, IN 47394-9436 | 2007-04-26 |
| 1730130238 | St. Vincent Randolph Hospital, Inc | Medicare Defined Swing Bed Unit | 473 E Greenville Ave, Winchester, IN 47394-9436 | 2006-05-12 |
| 1609826783 | St. Vincent Randolph Hospital, Inc. | General Acute Care Hospital | 473 E Greenville Ave, Winchester, IN 47394-9436 | 2006-05-11 |
| 1750330163 | David Brian Gudkese | Radiology | 473 E Greenville Ave, Winchester, IN 47394-9436 | 2006-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053889113 | Kristen Michelle Bogue | Nurse Practitioner | 910 E Washingon Street Suite 2, Winchester, IN 47394 | 2018-11-07 |
| 1972043305 | Lacie Shae Burge | Nurse Practitioner | 400 South Oak Street, Randolph Medical Center, Winchester, IN 47394 | 2017-03-04 |
| 1598018913 | Taylor L Stephens | Social Worker | 325 S Oak St, 103, Winchester, IN 47394 | 2012-10-23 |
| 1518189323 | Cari Prinkey | Pharmacist | 473 Greenville Avenue, Winchester, IN 47394 | 2007-05-02 |
| 1083708432 | Help-call & Rescue | Home Health | 605 West Newton, Winchester, IN 47394 | 2006-10-02 |
| 1548582950 | Samantha M Morris | Nurse Practitioner | 409 E Greenville Ave, Winchester, IN 47394 | 2010-02-26 |
| 1649271693 | S Kathryn Joyner | Nurse Practitioner | 409 E Greenville Ave, Winchester, IN 47394 | 2005-08-02 |
| 1184874331 | Dianna L. Naylor | Counselor | 730 W Washington St, Winchester, IN 47394-1425 | 2008-09-24 |
| 1619582673 | Kristen Lea Grilliot | Social Worker | 730 W Washington St, Winchester, IN 47394-1425 | 2020-09-15 |
| 1609245133 | Tonia Childers | Social Worker | 730 W Washington St, Winchester, IN 47394-1425 | 2015-09-15 |
| Find all providers in zip 47394 | ||||
| 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 |
|---|---|---|---|---|
| 1386989689 | Medexpress Urgent Care, PC - Virginia | Emergency Medicine | 207 Gateway Drive, Winchester, VA 22603 | 2012-11-28 |
| 1992903306 | Micah Shawn Crouse | Emergency Medicine | 1940 Taylor Dr Apt 6, Winchester, VA 22601-6338 | 2007-07-06 |
| 1245394246 | Robert Russell Dennison Jr. | Emergency Medicine | 108 Hidden Grove Ln, Winchester, KY 40391-8845 | 2006-12-21 |
| 1992863237 | Dennis Nelson Robertson | Emergency Medicine | 1107 W Lexington Avenue, Winchester, KY 40391-1169 | 2006-12-05 |
| 1225040215 | Nicholas Joseph O'shaughnessy | Emergency Medicine | 134 Johnson Rd, Winchester, MA 01890-3250 | 2006-08-12 |
| 1134147499 | Anita Gayle Rogers | Emergency Medicine | 505 Shoppers Dr, Suite 3, Winchester, KY 40391-2808 | 2006-07-17 |
| 1265471452 | Bradley Keith Robison | Emergency Medicine | 1033 S College St, Winchester, TN 37398-2262 | 2006-06-05 |
| 1629028782 | Christopher L Smith | Emergency Medicine | 821 Carter Farris Ln, Winchester, TN 37398-2978 | 2006-05-11 |
| 1679532394 | John Giangola | Emergency Medicine | 607 E Jubal Early Drive, Winchester, VA 22601-2808 | 2006-03-21 |
| 1407822760 | David John Watts | Emergency Medicine | 220 Campus Blvd, Winchester, VA 22601-2888 | 2006-02-27 |
| Find all providers in WINCHESTER | ||||
| City | WINCHESTER |
| Zip Code | 47394 |
Please comment or provide details below to improve the information on INDIANA PHYSICIAN MANAGEMENT-RANDOLPH, LLC.
| 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.