INDIANA NEURO-OPHTHALMOLOGY & CENTER FOR BALANCE (NPI# 1104989011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104989011 |
| Entity Type | Organization |
| Organization Name | INDIANA NEURO-OPHTHALMOLOGY & CENTER FOR BALANCE |
| Other Organization Name | BALANCEMD |
| Practice Address |
3721 Rome Dr Suite A Lafayette IN 47905-4408 |
| Practice Telephone | 7658077100 |
| Practice Fax Number | 7658077101 |
| Mailing Telephone | 7658077100 |
| Mailing Fax Number | 7658077101 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2019-10-02 |
| Authorized Official Name | SCOTT SANDERS (PRESIDENT) |
| Authorized Official Telephone | 7658077100 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
01045654 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ENCORE | 10019219 | 01 | |
| AETNA | 5776298 | 01 | |
| IN | ANTHEM | 000000507081 | 01 |
| CIGNA | 9239622 | 01 | |
| IN | MEDICARE RR | DF9084 | 01 |
| Other Name | Type Code |
|---|---|
| BalanceMD | Doing Business As Name - Organization |
| Street Address |
3721 ROME DR SUITE A |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47905-4408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902800576 | Scott K Sanders | Psychiatry & Neurology | 3721 Rome Dr, Suite A, Lafayette, IN 47905-4408 | 2005-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719893 | Elements Counseling LLC | Social Worker | 115 N. Farabee Drive, Lafayette, IN 47905 | 2019-09-18 |
| 1134596869 | Indiana Dental Sleep Therapy LLC | Dentist | 4921 Sr 26 E, Suite 300, Lafayette, IN 47905 | 2015-08-28 |
| 1255750899 | Emily S Miller | Physical Therapist | 1701 Creasy Ln, Lafayette, IN 47905 | 2014-04-10 |
| 1073876215 | Nathan Webster | Dentist | 1530 Kossuth St., Lafayette, IN 47905 | 2012-06-22 |
| 1578848370 | Mark Jin Kim | Pharmacist | 1801 South St., Lafayette, IN 47905 | 2011-10-13 |
| 1700177185 | Shannon Tawn Harris | Speech-Language Pathologist | 8900 Cobbler Lane, Lafayette, IN 47905 | 2011-04-20 |
| 1508164484 | David Thomas Beine | Specialist/Technologist | 1321 Unity Pl Ste A, Lafayette, IN 47905 | 2011-03-02 |
| 1447569538 | Deidre Dudley | Nurse Practitioner | 1701 S Creasy Ln Ste 1w93, Lafayette, IN 47905 | 2010-10-07 |
| 1548493067 | Unity Healthcare, LLC | Podiatrist | 750 Park East Blvd, Unit 4, Lafayette, IN 47905 | 2009-09-01 |
| 1073762969 | Lynette Marie Alexander | Nurse Practitioner | 5500 St Rd. 38 East, Lafayette, IN 47905 | 2008-09-16 |
| Find all providers in zip 47905 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548826803 | Brainwire LLC | Psychiatry & Neurology | 128 Keeneland Ln, Lafayette, LA 70503-6213 | 2019-05-13 |
| 1518385137 | Jonathan Kahn Jones | Psychiatry & Neurology | 4809 Ambassador Caffery Pkwy Ste 420, Lafayette, LA 70508-8802 | 2014-04-01 |
| 1114248994 | Stanley George Strauss | Psychiatry & Neurology | 2383 Lavender Hill Ln, Lafayette, CO 80026-9387 | 2010-06-16 |
| 1982806402 | Khaled Hammoud | Psychiatry & Neurology | 975 Mezzanine Dr Ste C, Lafayette, IN 47905-8635 | 2007-06-05 |
| 1104033992 | Damon Patterson | Psychiatry & Neurology | 136 Hospital Dr, Lafayette, LA 70503-2819 | 2007-05-17 |
| 1790815322 | Albert C Lee | Psychiatry & Neurology | 3731 Rome Dr, A, Lafayette, IN 47905-4490 | 2007-03-06 |
| 1649332248 | Lafayette Health Ventures, Inc. | Psychiatry & Neurology | 155 Hospital Dr., Ste #208, Lafayette, LA 70503 | 2006-12-14 |
| 1073531257 | Samuel Horton | Psychiatry & Neurology | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6633 | 2006-07-17 |
| 1154383313 | Wael Alabdulkarim | Psychiatry & Neurology | 1144 Coolidge Blvd Ste F, Lafayette, LA 70503-2622 | 2006-04-04 |
| 1063485936 | Ernest Edward Nitka | Psychiatry & Neurology | 300 Exempla Cir, Suite 230, Lafayette, CO 80026-3397 | 2006-02-09 |
| Find all providers in LAFAYETTE | ||||
Please comment or provide details below to improve the information on INDIANA NEURO-OPHTHALMOLOGY & CENTER FOR BALANCE.
| 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.