ALLERGY AND ASTHMA CENTER, INC (NPI# 1104913417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104913417 |
| Entity Type | Organization |
| Organization Name | ALLERGY AND ASTHMA CENTER, INC |
| Practice Address |
110 Fairway Dr Suite # 2 Wilmington OH 45177-8756 |
| Practice Telephone | 9376559179 |
| Practice Fax Number | 9376559139 |
| Mailing Telephone | 9376559179 |
| Mailing Fax Number | 9376559139 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. VIDYASHANKAR B REVAN (MD / PRESIDENT) |
| Authorized Official Telephone | 9376559179 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207K00000X | Allergy & Immunology | 35080833 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUECROSS AND BLUESHIELD | 000000237118 | 01 | |
| OH | 2321660 | 05 | |
| RAILROAD MEDICARE ID # | DD 2704 | 01 | |
| HUMANA / CHOICE CARE ID | D80833 | 01 | |
| UNITED HEALTH CARE | 0200482 | 01 |
| Street Address |
110 FAIRWAY DR SUITE # 2 |
| City | WILMINGTON |
| State | OH |
| Zip Code | 45177-8756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194882571 | Vidyashankar B Revan | Allergy & Immunology | 110 Fairway Dr, Suite # 2, Wilmington, OH 45177-8756 | 2007-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710542220 | Kratzer Pharmacy Inc. | Pharmacy | 187 W Locust St, Wilmington, OH 45177 | 2019-05-09 |
| 1639642754 | Jerrica Kimber Smith | Physical Therapy Assistant | 175 Cape May Dr., Therapy Suite, Wilmington, OH 45177 | 2019-01-11 |
| 1083187280 | Heather Freytag | Physical Therapy Assistant | 175 Cape May Drive, Wilmington, OH 45177 | 2019-01-10 |
| 1740780865 | Greater Tomorrow Wellness, LLC | Physician Assistant | 1097 W Locust St, Wilmington, OH 45177 | 2018-02-15 |
| 1144632431 | Orion Rehabilitation Center, Inc. | Day Training, Developmentally Disabled Services | 4595 State Route 730, Wilmington, OH 45177 | 2014-05-21 |
| 1841546975 | Kathleen Michelle Miller | Nurse Practitioner | 610 West Main Street, Emergency Department, Wilmington, OH 45177 | 2012-07-26 |
| 1952693590 | John K Loudermilk Inc. | Dentist | 260 W. Locust St., Wilmington, OH 45177 | 2011-05-13 |
| 1619209475 | Premier Health Care LLC | Clinic/Center | 2845 Progress Way, Wilmington, OH 45177 | 2010-02-04 |
| 1417179474 | Larry Alan Howard | Specialist/Technologist | Wilmington College, 1870 Quaker Way, Box 1246, Wilmington, OH 45177 | 2007-05-02 |
| 1659494425 | Alan Robert Thompson | Chiropractor | 39 North South Street, Wilmington, OH 45177 | 2007-04-09 |
| Find all providers in zip 45177 | ||||
| Taxonomy Code | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588034144 | Dimitri Zivko Pitovski | Allergy & Immunology | 1099 Medical Center Dr Unit 100b, Wilmington, NC 28401 | 2015-09-25 |
| 1518347095 | Michelle Marie Clark | Allergy & Immunology | 1600 Rockland Rd Ste 3d16, Wilmington, DE 19803 | 2015-06-01 |
| 1902217565 | Anusha Vadlamudi | Allergy & Immunology | 1017 Ashes Dr Ste 206, Wilmington, NC 28405-8308 | 2014-05-16 |
| 1548353345 | Leonard H Seltzer | Allergy & Immunology | 1309 Veale Rd, Suite 11, Wilmington, DE 19810-4609 | 2006-10-02 |
| 1760495097 | Michael Wydila | Allergy & Immunology | 1400 Philadelphia Pike, Suite A6, Wilmington, DE 19809 | 2006-08-15 |
| 1861470767 | Gregory V. Marcotte | Allergy & Immunology | 1700 Shallcross Ave, Suite 1, Wilmington, DE 19806-2344 | 2006-01-03 |
| 1831189992 | Allergy Partners, Pllc | Allergy & Immunology | 1017 Ashes Drive, Suite 206, Wilmington, NC 28405-8308 | 2005-10-28 |
| 1538159777 | Kenneth William Myers | Allergy & Immunology | 1017 Ashes Dr, Suite 206, Wilmington, NC 28405-8352 | 2005-10-27 |
| 1912997156 | Donald Miles Macqueen | Allergy & Immunology | 2321 Delaney Rd, Wilmington, NC 28403-6012 | 2005-10-27 |
| 1912904038 | David Peter Wien | Allergy & Immunology | 708 Greenbank Rd, Wilmington, DE 19808-3168 | 2005-07-05 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 45177 |
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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.