GERIATRIC PSYCHIATRIC SERVICES PLLC (NPI# 1306172788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306172788 |
| Entity Type | Organization |
| Organization Name | GERIATRIC PSYCHIATRIC SERVICES PLLC |
| Practice Address |
445 S County Road 525 E Avon IN 46123-8361 |
| Mailing Address |
1721 Moon Lake Blvd Suite 150 Hoffman Estates IL 60169-1069 |
| Practice Telephone | 3177452522 |
| Mailing Telephone | 8475193650 |
| Mailing Fax Number | 8475193652 |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2009-10-20 |
| Authorized Official Name | MR. ROBERT CLEMENTE (MANAGER) |
| Authorized Official Telephone | 8475193650 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | MEDICARE PTAN | IN260860 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235465659 | Geriatric Psychiatric Services Pllc | Psychologist | 2024 Adderbury Ln, Madison, WI 53711-4002 | 2009-10-20 |
| 1124273826 | Geriatric Psychiatric Services Pllc | Psychiatry & Neurology | 1 Westbrook Corp Ctr, Suite 300, Westchester, IL 60154-5701 | 2008-11-21 |
| 1467492173 | Geriatric Psychiatric Services Pllc | Psychologist | 1715 Indian Wood Cir Ste 200, Maumee, OH 43537-4055 | 2006-06-08 |
| 1891935144 | Geriatric Psychiatric Services Pllc | Nurse Practitioner | 9465 Counselors Row, Suite 200, Indianapolis, IN 46240-6423 | 2009-02-26 |
| 1528208873 | Geriatric Psychiatric Services Pllc | Social Worker | 1721 Moon Lake Blvd, Hoffman Estates, IL 60169-1069 | 2009-02-26 |
| 1073753323 | Geriatric Psychiatric Services Pllc | Psychologist | 9465 Counselors Row, Suite 200, Indianapolis, IN 46240-6423 | 2009-02-26 |
| 1881834125 | Geriatric Psychiatric Services Pllc | Psychiatry & Neurology | 9465 Counselors Row, Suite 200, Indianapolis, IN 46240-6423 | 2009-02-26 |
| 1801035902 | Geriatric Psychiatric Services Pllc | Psychiatry & Neurology | 363 W Big Beaver Rd, Suite 200, Troy, MI 48084-5220 | 2009-02-12 |
| 1538308630 | Geriatric Psychiatric Services Pllc | Psychologist | 1 Westbrook Corporate Ctr, Suite 300, Westchester, IL 60154-5701 | 2009-02-12 |
| 1730328832 | Geriatric Psychiatric Services Pllc | Nurse Practitioner | 1 Westbrook Corporate Ctr, Suite 300, Westchester, IL 60154-5701 | 2009-02-12 |
| Street Address |
445 S COUNTY ROAD 525 E |
| City | AVON |
| State | IN |
| Zip Code | 46123-8361 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043456627 | Vicki Lynn Eklof | Occupational Therapist | 445 S County Road 525 E, Avon, IN 46123-8361 | 2009-01-01 |
| 1285968073 | Jennifer Austin | Occupational Therapist | 445 S County Road 525 E, Avon, IN 46123-8361 | 2009-09-25 |
| 1851625776 | Alexandra Meghan Estes | Occupational Therapist | 445 S County Road 525 E, Avon, IN 46123-8361 | 2009-09-24 |
| 1457685612 | Michelle Baumgardner | Speech-Language Pathologist | 445 S County Road 525 E, Avon, IN 46123-8361 | 2009-09-21 |
| 1003149428 | David Neil Bratton | Physical Therapy Assistant | 445 S County Road 525 E, Avon, IN 46123-8361 | 2009-09-16 |
| 1881927481 | Jinger Cherri Dykes | Occupational Therapist | 445 S County Road 525 E, Avon, IN 46123-8361 | 2009-09-14 |
| 1497088009 | Christina Sunier | Occupational Therapist | 445 S County Road 525 E, Avon, IN 46123-8361 | 2009-09-14 |
| 1417280108 | Tonya R Boone | Physical Therapist | 445 S County Road 525 E, Avon, IN 46123-8361 | 2009-09-12 |
| 1134452824 | Wendy Nicole Walker | Occupational Therapist | 445 S County Road 525 E, Avon, IN 46123-8361 | 2009-09-12 |
| 1558694661 | Kristy J Behney | Physical Therapy Assistant | 445 S County Road 525 E, Avon, IN 46123-8361 | 2009-09-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669018669 | Dienye Williams | Pharmacist | 108 North Sr 267, Avon, IN 46123 | 2019-11-25 |
| 1992353817 | Debra Blackwell | Technician | 8198 Montage Ave, Apt 104, Avon, IN 46123 | 2019-09-04 |
| 1932675766 | Blake Ponist | Occupational Therapist | 10940 E U S Highway 36, Rockville Rd, Avon, IN 46123 | 2018-10-19 |
| 1396238150 | Sarah Sweany | Dietitian, Registered | Iu Health West Cancer Center, 1111 North Ronald Reagen Pkwy Suite B1600, Avon, IN 46123 | 2018-06-07 |
| 1124516257 | Sheree Itza | Counselor | 6655 E Us Highway 36 Ste 100, Avon, IN 46123 | 2018-04-24 |
| 1255860607 | Jonathan Lambert | Dentist | 110 N Avon Ave B, Avon, IN 46123 | 2017-06-08 |
| 1023546629 | 10439 E Us Highway 36 Dental, LLC | Dentist | 10439 E Us Highway 36, Avon, IN 46123 | 2017-05-25 |
| 1902330756 | Melissa Wheatley | Occupational Therapy Assistant | 6294 Forest View Court, Avon, IN 46123 | 2017-04-19 |
| 1932555844 | Gal Marcan | Family Medicine | 1351 Ronald Reagan Pkwy Ste B, Avon, IN 46123 | 2016-05-10 |
| 1962871301 | Annette Joelene Oechsle | Health Educator | 1820 South County Road 525 East, Avon, IN 46123 | 2015-09-16 |
| Find all providers in zip 46123 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093919771 | Avon Nursing Home, Inc. | Nursing Facility/Intermediate Care Facility | 1790 23rd Ave, Avon, IL 61415-9105 | 2007-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871040659 | Stephanie Hentrup | Nursing Facility/Intermediate Care Facility | 621 E 20th St, Ferdinand, IN 47532-9220 | 2016-09-08 |
| 1912354630 | Denise Chambery | Nursing Facility/Intermediate Care Facility | 5707 W 122nd Pl, Crown Point, IN 46307-8778 | 2016-05-23 |
| 1124494760 | Maplemanor Christian Home, Inc. | Nursing Facility/Intermediate Care Facility | 643 W Utica St, Sellersburg, IN 47172-1163 | 2015-08-18 |
| 1174868822 | Daviess County Hospital | Nursing Facility/Intermediate Care Facility | 120 East Miller Drive, Bloomington, IN 47407-6538 | 2012-12-06 |
| 1134493281 | Adams County Memorial Hospital | Nursing Facility/Intermediate Care Facility | 9802 Coldwater Road, Fort Wayne, IN 46825 | 2012-03-06 |
| 1447481049 | Larry Wayne Sims | Nursing Facility/Intermediate Care Facility | 1236 Lincoln Ave, Evansville, IN 47714-1056 | 2009-07-30 |
| 1720253313 | Davis Elderly Care, LLC | Nursing Facility/Intermediate Care Facility | 5139 S Hanover Saluda Rd, Hanover, IN 47243-9212 | 2008-04-24 |
| 1750585766 | Gosport Care, Inc. | Nursing Facility/Intermediate Care Facility | 27 S. 7th St., Gosport, IN 47433-0099 | 2007-06-13 |
| 1790986792 | Evansville Protestant Home Inc. | Nursing Facility/Intermediate Care Facility | 3701 Washington Ave, Evansville, IN 47714-0544 | 2007-05-29 |
| 1881816148 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 505 North Gavin Street, Muncie, IN 47303 | 2007-05-03 |
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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.