THEPPANYA K KEOLASY (NPI# 1124028881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124028881 |
| Entity Type | Individual |
| Full Name | THEPPANYA K KEOLASY |
| Credential | MD |
| Practice Address |
2003 Stults Rd Suite 100 Huntington IN 46750-1291 |
| Mailing Address |
1234 E Dupont Rd Suite 3 Fort Wayne IN 46825-1545 |
| Practice Telephone | 2603565424 |
| Practice Fax Number | 2603582090 |
| Mailing Telephone | 2603739700 |
| Mailing Fax Number | 2603739740 |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2010-08-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 01058795 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200956680 | 05 | |
| IN | ANTHEM | 000000655775 | 01 |
| IN | 200502100A | 05 |
| Street Address |
2003 STULTS RD SUITE 100 |
| City | HUNTINGTON |
| State | IN |
| Zip Code | 46750-1291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437158839 | Julie A Utendorf | Family Medicine | 2003 Stults Rd, Suite 100, Huntington, IN 46750-1291 | 2005-07-18 |
| 1720458664 | Jami Metzger | Nurse Practitioner | 2003 Stults Rd, Suite 100, Huntington, IN 46750-1291 | 2015-10-05 |
| 1992109391 | Megan Bobay | Dietitian, Registered | 2003 Stults Rd, Suite 105, Huntington, IN 46750-1291 | 2014-10-14 |
| 1114268125 | Stacey Marie Boswell | Physician Assistant | 2003 Stults Rd, Suite 120, Huntington, IN 46750-1291 | 2013-03-15 |
| 1902114655 | C. Bryan Wait, M.d., Internal Medicine, P.C. | Internal Medicine | 2003 Stults Rd, John B. Kay Mob, Suite 110, Huntington, IN 46750-1291 | 2010-09-15 |
| 1265558829 | Family Practice Associates, LLP | Clinic/Center | 2003 Stults Rd, Suite 100, Huntington, IN 46750-1291 | 2007-03-22 |
| 1871669473 | Parkview Health System, Inc. | Durable Medical Equipment & Medical Supplies | 2003 Stults Rd, Suite 215, Huntington, IN 46750-1291 | 2006-11-27 |
| 1154401230 | Vickie Jean Gayed | Nurse Practitioner | 2003 Stults Rd, Suite 100, Huntington, IN 46750-1291 | 2006-10-16 |
| 1932134590 | Kevin R. Stamm | Obstetrics & Gynecology | 2003 Stults Rd, Suite 120, Huntington, IN 46750-1291 | 2006-07-12 |
| 1649259607 | Orthopaedics Northeast, PC | Durable Medical Equipment & Medical Supplies | 2003 Stults Rd, Suite 210, Huntington, IN 46750-1291 | 2006-01-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457750457 | Michael Sands | Physical Therapist | 2001 Stults Road, Huntington, IN 46750 | 2014-08-15 |
| 1487917894 | Chelsi Huff | Speech-Language Pathologist | 1401 Park Hill Dr, Huntington, IN 46750 | 2012-06-20 |
| 1346540556 | Timothy Theye | Social Worker | 2860 Norhpark Ave., Huntington, IN 46750 | 2010-10-22 |
| 1710215090 | Manry Optometry, Inc. | Optometrist | 2932 Wal-mart Dr, Huntington, IN 46750 | 2009-11-25 |
| 1821114372 | Assisted Living Concepts Inc | Assisted Living Facility | 460 Forks of The Waba, Huntington, IN 46750 | 2007-03-22 |
| 1740316199 | Christine A Schnitz | Day Training/Habilitation Specialist | 435 Campus, Kids Kampus, Huntington, IN 46750 | 2007-02-27 |
| 1447397450 | Pathfinder Services Inc | Occupational Therapist | 435 Campus St, Huntington, IN 46750 | 2007-01-31 |
| 1487703781 | Sally Eileen Herman | Social Worker | 552 N Jefferson, Huntington, IN 46750 | 2007-01-09 |
| 1841356482 | Womens Medical Specialists | Obstetrics & Gynecology | 1060 Etna Avenue, Huntington, IN 46750 | 2006-12-28 |
| 1386748531 | Thomas J Ringenberg | Family Medicine | 941 Etna Ave, Huntington, IN 46750 | 2006-09-09 |
| Find all providers in zip 46750 | ||||
| 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 |
|---|---|---|---|---|
| 1326652868 | Grace Health Care Pllc | Family Medicine | 223 5th Ave, Huntington, WV 25701-1809 | 2020-09-02 |
| 1508347238 | Catherine Lea Chapman | Family Medicine | 1530 Norway Ave - Mildred Mitchel Bateman Hospital, Huntington, WV 25705 | 2018-08-21 |
| 1205364015 | Chi Hong Nguyen | Family Medicine | 8201 Newman Ave 101, Huntington, CA 92647 | 2017-05-24 |
| 1477926350 | Valley Health Systems, Inc | Family Medicine | 1 Mountwest Way, Huntington, WV 25701 | 2015-11-02 |
| 1689089666 | Ryan Allen | Family Medicine | 2003 Stults Rd # 100, Huntington, IN 46750-1291 | 2014-06-27 |
| 1700224359 | Juliette Kraydman | Family Medicine | 270 Huntington Avenue, Huntington, NY 11743 | 2013-06-05 |
| 1760766570 | Valley Health Systems, Inc. | Family Medicine | 730 7th Ave, Huntington, WV 25701-2116 | 2011-09-29 |
| 1023250305 | Rasiklal Haridas Lakhani | Family Medicine | 506 11th Ave W, Huntington, WV 25701-3032 | 2009-04-01 |
| 1114165784 | Cari C Burck | Family Medicine | 1115 20th St Ste 100, Huntington, WV 25703-2072 | 2009-02-04 |
| 1477717700 | Leigh Ann Levine, Do Pllc | Family Medicine | 2501 3rd Ave, Huntington, WV 25703-1614 | 2008-07-16 |
| Find all providers in HUNTINGTON | ||||
| City | HUNTINGTON |
| Zip Code | 46750 |
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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.