DECATUR VEIN CLINIC OF BLOOMINGTON, INC. (NPI# 1184812745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184812745 |
| Entity Type | Organization |
| Organization Name | DECATUR VEIN CLINIC OF BLOOMINGTON, INC. |
| Other Organization Name | DECATUR VEIN CLINIC |
| Practice Address |
3209 W Fullerton Pike Bloomington IN 47403-4057 |
| Mailing Address |
Po Box 4237 Carmel IN 46082-4237 |
| Practice Telephone | 8662184060 |
| Practice Fax Number | 8009581194 |
| Mailing Telephone | 3172182800 |
| Mailing Fax Number | 8009581194 |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2007-10-09 |
| Authorized Official Name | DAVID R DECATUR (CO-OWNER) |
| Authorized Official Telephone | 3172182800 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Decatur Vein Clinic | Doing Business As Name - Organization |
| Street Address |
3209 W FULLERTON PIKE |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47403-4057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336255900 | William J Schmalz | Internal Medicine | 3209 W Fullerton Pike, Suite E, Bloomington, IN 47403-4060 | 2006-08-23 |
| 1063068567 | Shanna Kay Klun | Registered Nurse | 3209 W Fullerton Pike, Bloomington, IN 47403-4060 | 2019-08-12 |
| 1033468715 | Vein Clinic LLC | Phlebology | 3209 W Fullerton Pike, Suite G, Bloomington, IN 47403-4060 | 2012-09-10 |
| 1033466495 | Varicose Vein Treatment Center | Phlebology | 3209 W Fullerton Pike, Suite C, Bloomington, IN 47403-4060 | 2012-08-04 |
| 1861672529 | Adamson Medical LLC | Family Medicine | 3209 W Fullerton Pike, Bloomington, IN 47403-4057 | 2007-11-11 |
| 1457570541 | Monroe Family Practice, LLC | Family Medicine | 3209 W Fullerton Pike, Suite B, Bloomington, IN 47403-4057 | 2007-04-25 |
| 1770626152 | Southern Indiana Family Practice Center PC | Nurse Practitioner | 3209 W Fullerton Pike, Ste A, Bloomington, IN 47403-4060 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043783673 | Brook Whitaker | Registered Nurse | 4011 S. Monroe Medical Park Blvd, Bloomington, IN 47403 | 2019-01-07 |
| 1598251175 | Jacob Edward Lundorf | Nurse Practitioner | 2100 S Liberty Dr Ste B, Bloomington, IN 47403 | 2018-07-06 |
| 1568973717 | Gregory Thomas Dougan | Physician Assistant | 418 South Landmark Avenue, Bloomington, IN 47403 | 2017-10-16 |
| 1295276160 | Indiana Center for Recovery, LLC | Substance Abuse Rehabilitation Facility | 1004 W 1st Street, Bloomington, IN 47403 | 2017-03-13 |
| 1144694217 | Kayla Dewolf | Specialist/Technologist | 1471 W Allen St, Bloomington, IN 47403 | 2015-11-30 |
| 1164806444 | Monroe Hosoital | General Acute Care Hospital | 4011 Monroe Medical Park, Bloomington, IN 47403 | 2015-07-16 |
| 1821411588 | Jennifer Turner | Occupational Therapy Assistant | 1023 West Main St, Swiss Villa, Vevay, IN 47403 | 2014-01-30 |
| 1104170232 | Kendall Basore | Social Worker | 445 S. Landmark Ave., Bloomington, IN 47403 | 2012-10-26 |
| 1568715886 | Indiana Hearing LLC | Hearing Aid Equipment | 2019 S Liberty Dr, Bloomington, IN 47403 | 2012-10-24 |
| 1679870232 | Accurate Hearing Services | Clinic/Center | 1355 W Second St, #3, Bloomington, IN 47403 | 2011-02-17 |
| Find all providers in zip 47403 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396938031 | Peripheral Vascular Care | Surgery | 640 S Walker St, Bloomington, IN 47403-2158 | 2007-08-27 |
| 1689622573 | Ricardo Vasquez | Surgery | 815 W 2nd St, Bloomington, IN 47403-2212 | 2006-05-04 |
| 1821067638 | Martin J Oneill Jr. | Surgery | 550 Landmark Ave, Bloomington, IN 47403 | 2006-03-15 |
| 1346369287 | Vascular Center & Vein Clinic of Southern Indiana | Surgery | 815 W 2nd St, Bloomington, IN 47403-2212 | 2007-03-29 |
| 1497752323 | John K Hamelink | Surgery | 550 S Landmark Ave, Bloomington, IN 47403-3239 | 2005-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801456603 | Wickel Vascular Surgery & Medicine PC | Surgery | 1919 State St Ste 444, New Albany, IN 47150-6809 | 2019-06-14 |
| 1154832178 | Allied Physicians of Michiana, LLC | Surgery | 611 E Douglas Rd Ste 308, Mishawaka, IN 46545-1465 | 2017-10-17 |
| 1194041764 | Andrew Alexander Gonzalez | Surgery | 1801 N Senate Blvd Ste 3500, Indianapolis, IN 46202-1184 | 2010-04-08 |
| 1649468364 | South Bend Vein Center for Excelllence, LLC | Surgery | 2025 Edison Rd, South Bend, IN 46637-5599 | 2007-10-09 |
| 1285841502 | Decatur Vein Clinic Hobart, PC | Surgery | 5043 E Lincoln Hwy, Merrillville, IN 46410-5912 | 2007-05-17 |
| 1093881385 | Decatur Vein Clinic, Michigan, PC | Surgery | 645 W Carmel Dr, Suite 101, Carmel, IN 46032-2605 | 2006-11-28 |
| 1962508853 | Indiana Phlebology PC | Surgery | 371 E 84th Dr Ste 371, Merrillville, IN 46410-6484 | 2006-09-16 |
| 1447361928 | The Heart and Vascular Clinic, P.C. | Surgery | 3251 Shawnee Drive South, Bedford, IN 47421 | 2006-08-31 |
| 1487761607 | Abdolaziz M Ardalan | Surgery | 9737 Decatur Dr, Indianapolis, IN 46256-9656 | 2006-08-24 |
| 1851315618 | William R Finkelmeier | Surgery | 13450 N Meridian St Ste 160, Carmel, IN 46032-1552 | 2006-07-26 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 47403 |
Please comment or provide details below to improve the information on DECATUR VEIN CLINIC OF BLOOMINGTON, INC..
| 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.