TRI STATE COMMUNITY CLINIC, LLC (NPI# 1104317346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104317346 |
| Entity Type | Organization |
| Organization Name | TRI STATE COMMUNITY CLINIC, LLC |
| Practice Address |
1033 E Mt. Pleasant Rd., Ste. D. Evansville IN 47725 |
| Mailing Address |
1033 E Mt. Pleasant Rd., Ste. D Evansville IN 47725 |
| Practice Telephone | 8884928722 |
| Practice Fax Number | 8124910333 |
| Mailing Telephone | 8884928722 |
| Mailing Fax Number | 8124910333 |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-05-23 |
| Authorized Official Name | RONALD CHAD PERKINS (CMO) |
| Authorized Official Telephone | 8884928722 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
1033 E MT. PLEASANT RD., STE. D. |
| City | EVANSVILLE |
| State | IN |
| Zip Code | 47725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235502774 | Hook-superx, L.L.C. | Registered Nurse | 600 E Boonville New Harmony Rd, Evansville, IN 47725 | 2015-11-05 |
| 1346556388 | Hook-superx, L.L.C. | Durable Medical Equipment & Medical Supplies | 511 E. Boonville - New Harmony Rd, Evansville, IN 47725 | 2010-08-27 |
| 1720112071 | Roger Lee Tindle | Pharmacist | 12500 N Hwy 41, Evansville, IN 47725 | 2007-03-16 |
| 1750413670 | Elizabeth Marilyn Hobbs | Physical Therapy Assistant | 8700a N. Kentucky Ave, Evansville North -phr, Evansville, IN 47725 | 2007-03-09 |
| 1134215841 | Cindy K Mcwilliams | Speech-Language Pathologist | 15601 Darmstadt Road, Evansville, IN 47725 | 2006-10-04 |
| 1891735171 | Brian Becker | Anesthesiology | 13000 Woodland Ln, Evansville, IN 47725 | 2006-06-07 |
| 1003311309 | Megan E Tate | Nurse Practitioner | 8600 N Kentucky Ave, Evansville, IN 47725 | 2018-03-28 |
| 1316497811 | St. Mary's Medical Center of Evansville | Pharmacy | 14020 Old State Rd, Evansville, IN 47725 | 2016-10-07 |
| 1730560376 | Megan J York | Pediatrics | 14020 Old State Rd # 300, Evansville, IN 47725 | 2015-06-09 |
| 1760864987 | Jared D Mitchell | Family Medicine | 14020 Old State Rd Ste 100, Evansville, IN 47725-1121 | 2015-06-24 |
| Find all providers in zip 47725 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528557840 | Deaconess Clinic, Inc. | Family Medicine | 2007 W Franklin St Ste B, Evansville, IN 47712 | 2018-05-02 |
| 1598252652 | Herbert Dan Adams | Family Medicine | 501 Wyndclyff Dr, Evansville, IN 47711-2789 | 2018-04-15 |
| 1326568775 | Midwest Scope LLC | Family Medicine | 1401 Professional Blvd Ste 100, Evansville, IN 47714-8011 | 2017-06-26 |
| 1609303015 | Kyle Lemond | Family Medicine | 1000 S Green River Rd, Evansville, IN 47715-6802 | 2017-05-16 |
| 1871944041 | Anne Alexis | Family Medicine | 3801 Bellemeade Ave Ste 200b, Evansville, IN 47714-0114 | 2016-06-28 |
| 1760864987 | Jared D Mitchell | Family Medicine | 14020 Old State Rd Ste 100, Evansville, IN 47725-1121 | 2015-06-24 |
| 1396126710 | Lynniece A Kocher | Family Medicine | 8600 N Kentucky Avenue, Evansville, IN 47722 | 2015-06-11 |
| 1205194677 | Sanders Medical, LLC | Family Medicine | 2516 Washington Ave, Evansville, IN 47714-2404 | 2012-04-24 |
| 1194090308 | Kenneth E Yagodich, Md, PC | Family Medicine | 1200 Heinlein Rd, Evansville, IN 47725-6379 | 2012-03-21 |
| 1134499320 | Vivien Tucker, Md, LLC | Family Medicine | 13330 Darmstadt Rd, Evansville, IN 47725-9593 | 2012-01-05 |
| Find all providers in EVANSVILLE | ||||
| City | EVANSVILLE |
| Zip Code | 47725 |
Please comment or provide details below to improve the information on TRI STATE COMMUNITY CLINIC, 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.