MIND MD LLC (NPI# 1215334008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215334008 |
| Entity Type | Organization |
| Organization Name | MIND MD LLC |
| Practice Address |
833 Park East Blvd Lafayette IN 47905-0785 |
| Mailing Address |
Po Box 182255 Columbus OH 43218-2255 |
| Practice Telephone | 7657434400 |
| Practice Fax Number | 7657434411 |
| Mailing Telephone | 6144305707 |
| Mailing Fax Number | 6144305744 |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2014-11-24 |
| Authorized Official Name | DR. SYED J KHAN (OWNER) |
| Authorized Official Telephone | 3474324848 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
01061501A | IN | Allopathic & Osteopathic Physicians |
| Street Address |
833 PARK EAST BLVD |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47905-0785 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477832772 | Sycamore Springs, LLC | Psychiatric Hospital | 833 Park East Blvd, Lafayette, IN 47905-0785 | 2011-08-04 |
| 1235737081 | Jennifer Erdman | Physician Assistant | 833 Park East Blvd, Lafayette, IN 47905-0785 | 2020-10-14 |
| 1427613447 | Timothy Poquette | Nurse Practitioner | 833 Park East Blvd, Lafayette, IN 47905-0785 | 2019-05-06 |
| 1639695067 | Katherine Marie Hafer | Nurse Practitioner | 833 Park East Blvd, Lafayette, IN 47905-0785 | 2017-08-17 |
| 1053780718 | Elizabeth Mcquinn | Clinical Nurse Specialist | 833 Park East Blvd, Lafayette, IN 47905-0785 | 2015-09-23 |
| 1972914539 | Sycamore Springs Physician Group LLC | Internal Medicine | 833 Park East Blvd, Lafayette, IN 47905-0785 | 2014-05-16 |
| 1235568734 | Sycamore Springs, LLC | Family Medicine | 833 Park East Blvd, Lafayette, IN 47905-0785 | 2013-11-05 |
| 1700158383 | Institutional Pharmacy Solutions LLC | Pharmacy | 833 Park East Blvd, Lafayette, IN 47905-0785 | 2012-01-30 |
| 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 | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750808911 | One Telemed LLC | Psychiatry & Neurology | 1001 W Pinhook Road, Building 3 Suite 219, Lafayette, LA 70503 | 2017-08-28 |
| 1194196535 | Advance Telehealth Consulting Solutions, LLC | Psychiatry & Neurology | 1001 W. Pinhook Road, Building 3 Suite 219, Lafayette, LA 70503 | 2015-10-12 |
| 1417214164 | Nicholas Lawrence Lavin | Psychiatry & Neurology | 913 S College Rd Ste 102, Lafayette, LA 70503-3061 | 2012-04-19 |
| 1336207216 | Ching-shih Hu | Psychiatry & Neurology | 302 Dulles Dr, Lafayette, LA 70506-3008 | 2006-12-04 |
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|---|---|---|---|---|
| 1659695278 | Harmony Medical Associates LLC | Psychiatry & Neurology | 11837 Wedgeport Ln, Fishers, IN 46037-7987 | 2010-03-25 |
| 1508046624 | Kearn D Hinchman D O Inc | Psychiatry & Neurology | 53779 Generations Dr Ste 1, South Bend, IN 46635-1576 | 2007-11-06 |
| 1144337791 | Benjamin Louis Troy | Psychiatry & Neurology | 230 East Day Road, Suite 160, Mishawaka, IN 46545-3463 | 2006-08-23 |
| 1770526618 | Elizabeth A Taylor | Psychiatry & Neurology | 3055 N Lake Ct, Newburgh, IN 47630 | 2006-06-14 |
| 1407807746 | Syed J Khan | Psychiatry & Neurology | 10765 Lantern Road, Suite 102, Fishers, IN 46038-3597 | 2006-05-12 |
| 1821060294 | Michael Welling | Psychiatry & Neurology | 2040 Shadeland Ave, Ste 200, Indianapolis, IN 46219-1734 | 2006-02-01 |
| 1184616294 | Fadia T Aldahan | Psychiatry & Neurology | 5502 East 16th Street, Suite A21, Indianapolis, IN 46218-4932 | 2005-08-16 |
| 1700337920 | Kledzik Psychiatric LLC | Psychiatry & Neurology | 9245 N Meridian St, 225, Indianapolis, IN 46260-1836 | 2016-10-24 |
| 1255714390 | Ahmed Montaser | Psychiatry & Neurology | 121 Buntin St, Vincennes, IN 47591-1320 | 2015-07-07 |
| 1326458514 | Ambreen Khan Ghori | Psychiatry & Neurology | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2014-04-28 |
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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.