DR. TIMOTHY JAMES VON FANGE (NPI# 1154461739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154461739 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY JAMES VON FANGE |
| Credential | MD |
| Practice Address |
3201 Middle Dr Columbus IN 47203-4427 |
| Mailing Address |
Po Box 775383 Chicago IL 60677-5383 |
| Practice Telephone | 8123728281 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-10-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 01068721A | IN | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 036-121122 | IL | Allopathic & Osteopathic Physicians |
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
01068721A | IN | Allopathic & Osteopathic Physicians |
| N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
036-121122 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036121122 | 05 |
| Street Address |
3201 MIDDLE DR |
| City | COLUMBUS |
| State | IN |
| Zip Code | 47203-4427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144294125 | Jason Konrad King | Specialist | 3201 Middle Dr, Columbus, IN 47203-4427 | 2006-02-15 |
| 1871103754 | Kellie Hollan | Nurse Practitioner | 3201 Middle Dr, Columbus, IN 47203-4427 | 2020-08-05 |
| 1457708885 | Angela Nielsen | Nurse Practitioner | 3201 Middle Dr, Columbus, IN 47203-4427 | 2016-05-16 |
| 1063618445 | Kelly R Burse | Family Medicine | 3201 Middle Dr, Columbus, IN 47203-4427 | 2007-06-22 |
| 1922209709 | Alyssa Morgan Lovell | Family Medicine | 3201 Middle Dr, Columbus, IN 47203-4427 | 2007-05-30 |
| 1033296561 | Janet Ann Callon | Nurse Practitioner | 3201 Middle Dr, Columbus, IN 47203-4427 | 2006-11-01 |
| 1033218664 | David Rau | Family Medicine | 3201 Middle Dr, Columbus, IN 47203-4427 | 2006-09-21 |
| 1245252600 | William F Lustig | Family Medicine | 3201 Middle Dr, Columbus, IN 47203-4427 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649767955 | Sean Meador | Pharmacist | 3630 31st Street, Columbus, IN 47203 | 2018-04-23 |
| 1013319367 | Sandra Smith | Nurse Practitioner | 2329 North Marr Road, Wow Clinic, Columbus, IN 47203 | 2014-09-18 |
| 1174939680 | Hana Hoffman | Occupational Therapist | 2625 Foxpointe Dr., Suite A, Columbus, IN 47203 | 2014-07-03 |
| 1801219209 | Michelle Ann Ballard | Alzheimer Center (Dementia Center) | 2564 Foxpointe Drive, Keepsake Village, Columbus, IN 47203 | 2014-01-22 |
| 1639454606 | Jaime Denise Miller | Physical Therapist | 2625 Foxpointe Dr. 3a, Columbus, IN 47203 | 2011-10-20 |
| 1538443155 | Jessica Paige Laymon | Social Worker | 1680 Whitney Court, Columbus, IN 47203 | 2011-09-30 |
| 1720375124 | Hannah C Burke | Physical Therapist | 2625 Foxpointe Dr, Columbus, IN 47203 | 2011-07-06 |
| 1033419437 | Patricia J. Lisinski | Physician Assistant | 2510 Sandcrest Drive, Columbus, IN 47203 | 2010-11-01 |
| 1245495175 | David Brent Gadberry | Registered Nurse | 2122 Sumpter Trl, Columbus, IN 47203 | 2008-07-21 |
| 1710003231 | Ellen H Rudolph | Dentist | 3200 Sycamore Ct. Suite 1-c, Columbus, IN 47203 | 2007-03-22 |
| Find all providers in zip 47203 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477597979 | John M. Henderson Sr. | Family Medicine | 1900 10th Ave Suite 320, Columbus, GA 31901 | 2006-06-15 |
| 1457346058 | Richard Martin | Family Medicine | 50 Mcnaughten Rd Ste 202, Columbus, OH 43213-2193 | 2005-09-20 |
| 1962964833 | Hughston Medical Group, PC | Family Medicine | 1900 10th Ave Ste 211, Columbus, GA 31901-3604 | 2019-04-01 |
| 1184078644 | Margaret Doe | Family Medicine | 543 Taylor Ave Fl 2, Columbus, OH 43203-1278 | 2016-04-20 |
| 1164717260 | Benjamin Jacob Burkam | Family Medicine | 697 Thomas Ln, Columbus, OH 43214 | 2011-06-16 |
| 1619276656 | Ohiohealth Corporation | Family Medicine | 3705 Olentangy River Rd Ste 260, Columbus, OH 43214-3467 | 2011-03-16 |
| 1093950560 | Grant/riverside Medical Care Foundation, Inc | Family Medicine | 3705 Olentangy River Rd, Ste 260, Columbus, OH 43214-3467 | 2008-12-11 |
| 1699947176 | John M Henderson Do PC | Family Medicine | 2300 Manchester Expy, Bldg G202, Columbus, GA 31904-6802 | 2008-03-25 |
| 1982809273 | John W Diehl | Family Medicine | 3773 Olentangy River Rd, Columbus, OH 43214-3425 | 2007-06-18 |
| 1558446765 | Kiersten W Arthur | Family Medicine | 700 Childrens Dr, Columbus, OH 43205-2664 | 2006-10-26 |
| Find all providers in COLUMBUS | ||||
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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.