DR. KENNETH H. HALLER (NPI# 1295741197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295741197 |
| Entity Type | Individual |
| Full Name | DR. KENNETH H. HALLER |
| Credential | DO |
| Practice Address |
3600 W Bethel Ave Muncie IN 47304-5407 |
| Mailing Address |
Po Box 1643 Muncie IN 47308-1643 |
| Practice Telephone | 7652847738 |
| Practice Fax Number | 7652133713 |
| Mailing Telephone | 7652847738 |
| Mailing Fax Number | 7652133713 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2014-01-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
02001656A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | RAILROAD MEDICARE | 250009136 | 01 |
| IN | ANTHEM PIN | 000000087018 | 01 |
| IN | 200064610 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679584304 | Kenneth A Haller | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2006-08-10 |
| Street Address |
3600 W BETHEL AVE |
| City | MUNCIE |
| State | IN |
| Zip Code | 47304-5407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700882396 | Matthew T Dewitt | Podiatrist | 3600 W Bethel Ave, Muncie, IN 47304 | 2005-06-28 |
| 1376151456 | Curtis Lee Laws | Nurse Practitioner | 3600 W Bethel Ave, Muncie, IN 47304-5407 | 2020-07-15 |
| 1124587035 | Cio Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 3600 W Bethel Ave, Muncie, IN 47304-5407 | 2019-03-19 |
| 1578036265 | Tricia M James | Nurse Practitioner | 3600 W Bethel Ave, Muncie, IN 47304-5407 | 2019-01-07 |
| 1164917050 | Central Indiana Orthopedic Surgery Center, LLC | Clinic/Center | 3600 W Bethel Ave, Muncie, IN 47304-5407 | 2018-06-25 |
| 1346751930 | Elizabeth Gertrude Wendel | Physical Therapy Assistant | 3600 W Bethel Ave, Muncie, IN 47304-5407 | 2017-10-23 |
| 1801347299 | Joseph Richichi | Physician Assistant | 3600 W Bethel Ave, Muncie, IN 47304-5407 | 2016-10-20 |
| 1891246559 | U.S. Healthworks Medical Group of Indiana, PC | Clinic/Center | 3600 W Bethel Ave, Muncie, IN 47304-5407 | 2016-10-18 |
| 1164972071 | Ericka Lynn Lennartz | Physical Therapy Assistant | 3600 W Bethel Ave, Muncie, IN 47304-5407 | 2016-10-04 |
| 1114476611 | Karissa Carpenter | Physician Assistant | 3600 W Bethel Ave, Muncie, IN 47304-5407 | 2016-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821627191 | Free To Flourish Counseling and Consulting | Marriage & Family Therapist | 4304 W Coyote Run Court, Muncie, IN 47304 | 2020-04-07 |
| 1205477957 | Muncie Treatment Center, LLC | Clinic/Center | 3640 Briarwood Lane, Muncie, IN 47304 | 2019-10-03 |
| 1508415225 | Susanna Florence Nalliah I | Pharmacist | Iu Health Ball Memorial Hospital Inpatient Pharmacy, 2401 W. University Ave, Muncie, IN 47304 | 2019-09-05 |
| 1235624289 | Kregg Koons O.d., Inc. | Optometrist | 3300 Purdue Ave., Muncie, IN 47304 | 2018-06-22 |
| 1013409242 | Julia Powers | Social Worker | 8425 W Ashford Ln, Muncie, IN 47304 | 2018-06-04 |
| 1851803456 | Dianna Marie Johnson | Nurse Practitioner | 3411 N Briarwood Ln, Muncie, IN 47304 | 2017-11-04 |
| 1780082917 | Quad Med LLC | Clinic/Center | 3800 West Kilgore Ave, Muncie, IN 47304 | 2014-12-22 |
| 1629418173 | Mark Allen Wise | Physical Therapist | 3607 N Everbrook Lane, Muncie, IN 47304 | 2013-06-28 |
| 1396094280 | Planned Parenthood of Indiana Muncie | Clinic/Center | 3550 W. Fox Ridge Lane, Muncie, IN 47304 | 2012-09-06 |
| 1043595655 | Olukayode Bamidele | Physical Therapist | 3601 W. Moore Road, Muncie, IN 47304 | 2011-10-14 |
| Find all providers in zip 47304 | ||||
| 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 |
|---|---|---|---|---|
| 1295137925 | Ball State University | Family Medicine | Hp 260, Muncie, IN 47306-0001 | 2014-09-25 |
| 1225144744 | Central Indiana Orthopedics PC | Family Medicine | 3631 N Morrison Rd, Suite 200, Muncie, IN 47304-5547 | 2006-08-21 |
| 1124034038 | Jeremy J. Hunt | Family Medicine | 3600 W Bethel Ave, Muncie, IN 47304-5407 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962061135 | Central Indiana Orthopedics, PC | Family Medicine | 14300 E 138th Bldg B, Fishers, IN 46037-0087 | 2019-06-11 |
| 1104326909 | Orthopaedic Associates, Inc. | Family Medicine | 4011 Gateway Blvd Ste 100, Newburgh, IN 47630-8947 | 2018-02-19 |
| 1700231313 | Heather Saffel | Family Medicine | 111 W Jefferson Blvd Ste 100, South Bend, IN 46601-1993 | 2016-05-02 |
| 1922477686 | Orthopaedic Associates, Inc. | Family Medicine | 5828 Pearl Dr, Evansville, IN 47712-8116 | 2015-09-23 |
| 1992118822 | Zachary Conner Ritchie | Family Medicine | 301 Satori Pkwy Ste 120, Avon, IN 46123-6407 | 2014-06-09 |
| 1740692078 | Joel Jaeger | Family Medicine | 275 W Bassett Rd Ste 3, Shelbyville, IN 46176-8575 | 2014-05-21 |
| 1457652992 | Martha Ann Taylor | Family Medicine | 105 Hendron Hills Dr, Vincennes, IN 47591-3638 | 2010-11-16 |
| 1649598707 | Rajih Y Haddawi | Family Medicine | 2631 S Atlee St, Bloomington, IN 47401-4536 | 2010-05-12 |
| 1538300561 | Michael Robert Messmer | Family Medicine | 3221 Beacon Parkway, Granger, IN 46530 | 2009-03-21 |
| 1558551382 | Jerry Edward Blythe | Family Medicine | 8045 Broadway St, Indianapolis, IN 46240-2502 | 2007-07-27 |
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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.