KIDNEY AND HYPERTENSION CENTER OF IN (NPI# 1174675789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174675789 |
| Entity Type | Organization |
| Organization Name | KIDNEY AND HYPERTENSION CENTER OF IN |
| Practice Address |
2229 Mary Sherman Dr Sullivan IN 47882-7633 |
| Mailing Address |
3740 S 4th St Terre Haute IN 47802-5507 |
| Practice Telephone | 8122323900 |
| Practice Fax Number | 8122323955 |
| Mailing Telephone | 8122323900 |
| Mailing Fax Number | 8122323955 |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SHERIF ELASSAL (OWNER) |
| Authorized Official Telephone | 8122323900 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
01052996 | IN | Allopathic & Osteopathic Physicians |
| Street Address |
2229 MARY SHERMAN DR |
| City | SULLIVAN |
| State | IN |
| Zip Code | 47882-7633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952304123 | Carl F. Conwell | Family Medicine | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2005-05-23 |
| 1447805965 | Sullivan County Community Hospital | Family Medicine | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2019-08-02 |
| 1073042131 | Jeanna Rennee Lisman | Nurse Practitioner | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2017-06-12 |
| 1700256948 | Mso Clinics, Inc. | Clinic/Center | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2015-09-30 |
| 1811317977 | Mso Clinics, Inc. | Clinic/Center | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2014-04-16 |
| 1467884643 | Sullivan County Community Hospital | Clinic/Center | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2013-07-30 |
| 1316270747 | Union Associated Physicians Clinic, LLC | Otolaryngology | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2009-09-17 |
| 1053576405 | Terri Lee Brown | Nurse Practitioner | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2008-07-25 |
| 1427275353 | Jessy G. Woods | Internal Medicine | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2007-04-20 |
| 1427119809 | Terre Haute Pulmonary & Pediatric Clinic, LLC | Internal Medicine | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2006-12-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659718336 | Neil Lynn Smith | Dentist | 118 S. Court St., Sullivan, IN 47882 | 2013-06-04 |
| 1184888000 | Mary Sherman Hospital | Hospice Care, Community Based | 817 North Section Street, Suite A, Sullivan, IN 47882 | 2008-07-10 |
| 1003838194 | Johnson Memorial Hospital | Durable Medical Equipment & Medical Supplies | 505 West Wolfe Street, Sullivan, IN 47882 | 2006-07-24 |
| 1255580593 | Daniel Choyce Callahan | Psychiatry & Neurology | 2204 N Section St, Sullivan, IN 47882 | 2008-09-11 |
| 1851394175 | Van Evanoff Jr. | Pain Medicine | 2204 N Section St, Suite B, Sullivan, IN 47882-0010 | 2005-05-31 |
| 1982780748 | Associated Physicians & Surgeons Clinic, LLC | Obstetrics & Gynecology | 2204 N Section St, Suite B, Sullivan, IN 47882-0010 | 2006-10-27 |
| 1871996199 | Sullivan Family Dentistry, LLC | Dentist | 2186 N Hospital Blvd., Suite 1, Sullivan, IN 47882-0468 | 2014-10-01 |
| 1487828455 | Kortni Reann Martindale | Speech-Language Pathologist | 368 W Indiana Ave, Sullivan, IN 47882-1117 | 2008-04-21 |
| 1831280585 | Southwest School Corporation | Local Education Agency (LEA) | 110 N Main St, Sullivan, IN 47882-1225 | 2006-09-27 |
| 1780717637 | Brian K Grindstaff | Chiropractor | 210 N Section St Unit C, Sullivan, IN 47882-1237 | 2007-03-13 |
| Find all providers in zip 47882 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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| 1225684368 | Fort Wayne Vascular Care LLC | Internal Medicine | 1833 Magnavox Way # 100, Fort Wayne, IN 46804-1539 | 2019-08-14 |
| 1952962516 | Rafael Juan Igartua | Internal Medicine | 1450 Solemar Dr, West Lafayette, IN 47906-8867 | 2019-06-25 |
| 1215463955 | William Louis Macias | Internal Medicine | 9129 Log Run Dr S, Indianapolis, IN 46234-1343 | 2017-05-01 |
| 1538612015 | Muhammad Ziad Souqiyyeh | Internal Medicine | 3100 Village Pt Ste 102, Chesterton, IN 46304 | 2016-08-01 |
| 1679924013 | Peter Eloho Umukoro | Internal Medicine | 950 W Walnut St Rm 202, Indianapolis, IN 46202 | 2016-06-27 |
| 1124423546 | Beacon Medical Group, Inc. | Internal Medicine | 100 Navarre Pl Ste 4400, South Bend, IN 46601-1100 | 2014-10-28 |
| 1619309317 | Kevin Joseph Lavelle | Internal Medicine | 621 First Ave. N.e., Carmel, IN 46032 | 2013-08-05 |
| 1215270897 | Lori Wanko | Internal Medicine | 8205 E 56th St Ste 250, Indianapolis, IN 46216-1097 | 2013-04-01 |
| 1326319724 | Robert Wayne Dettmer | Internal Medicine | 2935 Ambleside Way, Fort Wayne, IN 46804-2443 | 2012-01-18 |
| 1265747703 | Yasser Aldurra | Internal Medicine | 8330 Naab Rd Ste 234, Indianapolis, IN 46260-1932 | 2010-08-09 |
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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.