PEDIATRIC PULMONARY & CRITICAL CARE, PC (NPI# 1225169196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225169196 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC PULMONARY & CRITICAL CARE, PC |
| Practice Address |
7910 West Jefferson Blvd. Ste 205 Fort Wayne IN 46804-4159 |
| Mailing Address |
Pmb 218 10214 Chestnut Plaza Drive Fort Wayne IN 46814-8970 |
| Practice Telephone | 2604357800 |
| Practice Fax Number | 2604357007 |
| Mailing Telephone | 2604357800 |
| Mailing Fax Number | 2604357007 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2012-03-06 |
| Authorized Official Name | CHANDRASHEKHAR CHOWDARY YALAMANCHALI (OWNER/PRESIDENT) |
| Authorized Official Telephone | 2604357800 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
01049779A | IN | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2080P0214X |
Pediatrics Specialization: Pediatric Pulmonology |
Allopathic & Osteopathic Physicians | ||
| Y | 2080P0214X |
Pediatrics Specialization: Pediatric Pulmonology |
01049779A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200500220 | 05 | |
| IN | 200231310 | 05 | |
| IN | 200246880 | 05 |
| Street Address |
7910 WEST JEFFERSON BLVD. STE 205 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-4159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 2080P0214X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Pulmonology |
| A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801943857 | Rajeswary Padmalingam | Pediatrics | 7950 W Jefferson Blvd, Suite 205, Fort Wayne, IN 46804-4140 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932126968 | James F Chmiel | Pediatrics | 705 Riley Hospital Dr # 4270, Indianapolis, IN 46202-5109 | 2006-07-16 |
| 1336556943 | Sandeep Puranik | Pediatrics | 705 Riley Hospital Dr, Roc 4270, Indianapolis, IN 46202-5109 | 2014-07-15 |
| 1578901401 | Kristen Noel Ameel | Pediatrics | 705 Riley Hospital Dr Rm 5867, Indianapolis, IN 46202-5109 | 2013-06-13 |
| 1992142004 | Heather Nicole Muston | Pediatrics | 705 Riley Hospital Dr # 4270, Indianapolis, IN 46202-5109 | 2013-05-30 |
| 1134431489 | Anuja Bandyopadhyay | Pediatrics | 705 Riley Hospital Drive, Roc 4270, Indianapolis, IN 46202 | 2010-07-01 |
| 1295054542 | Angela O. Delecaris | Pediatrics | 705 Riley Hospital Dr, Roc 4270, Indianapolis, IN 46202-5109 | 2010-05-26 |
| 1871755884 | Evans Miruka Machogu | Pediatrics | 705 Riley Hospital Dr, Roc 4270, Indianapolis, IN 46202-5109 | 2008-06-30 |
| 1477724862 | Aura Ioana Cristea | Pediatrics | 705 Riley Hospital Dr, Roc 4270, Indianapolis, IN 46202-5109 | 2008-03-13 |
| 1356535017 | Harish Sulibele Raghavendra Rao | Pediatrics | 705 Riley Hospital Dr, Roc 4270, Indianapolis, IN 46202-5109 | 2007-09-05 |
| 1902016967 | Nadia Lynn Krupp | Pediatrics | 705 Riley Hospital Dr, Roc 4270, Indianapolis, IN 46202-5109 | 2007-05-22 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
Please comment or provide details below to improve the information on PEDIATRIC PULMONARY & CRITICAL CARE, PC.
| 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.