HEATHER BOLAN (NPI# 1336519685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336519685 |
| Entity Type | Individual |
| Full Name | HEATHER BOLAN |
| Practice Address |
3630 Willowcreek Rd Portage IN 46368-5075 |
| Mailing Address |
9460 W Oakridge Dr Saint John IN 46373-9212 |
| Practice Telephone | 2193643000 |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2015-09-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 46002738A | IN | Speech, Language and Hearing Service Providers |
| Street Address |
3630 WILLOWCREEK RD |
| City | PORTAGE |
| State | IN |
| Zip Code | 46368-5075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720074701 | Muhammad Q. Choudry | Emergency Medicine | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2005-09-23 |
| 1396383881 | Jed Leifson | Registered Nurse | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2019-12-15 |
| 1508411315 | Chad Anthony Bogue | Nurse Practitioner | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2019-08-08 |
| 1366961757 | Cristina Lubash | Nurse Practitioner | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2017-09-17 |
| 1114468501 | Victoria Anne Pyke | Nurse Practitioner | 3630 Willowcreek Rd, Portage, IN 46368 | 2017-03-17 |
| 1346616646 | Porter Group Services, LLC | Hospitalist | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2015-08-20 |
| 1033507538 | Atlantic Silverside Emergency Physicians LLC | Physician Assistant | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2015-01-06 |
| 1235546516 | Reuel Young Uy | Internal Medicine | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2014-07-17 |
| 1124452628 | Ranga Kota Md, PC | Internal Medicine | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2013-09-03 |
| 1891135620 | Kajal Patel Puranik | Family Medicine | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2013-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1831576693 | Bishara Robert Khoury | Family Medicine | 3545 Arbor Blvd Ste E, Portage, IN 46368 | 2015-04-30 |
| 1962813535 | Diane Farrington | Pharmacist | 6050 Us Hwy 6, Portage, IN 46368 | 2014-05-16 |
| 1588827562 | Jennifer Ann Rumpel | Allergy & Immunology | 6375 Us Highway 6 Ste C, Portage, IN 46368 | 2008-07-09 |
| 1588822688 | Total Renal Care Inc | Clinic/Center | 5823 Us Highway 6, Portage, IN 46368 | 2008-05-27 |
| 1235321480 | Michael Wendahl | Physical Therapist | 3691 Willowcreek Road, Suite 100, Portage, IN 46368 | 2007-08-13 |
| 1679663603 | Stephen V Headley | Family Medicine | 3283 Willowcreek Rd, Portage, IN 46368 | 2006-10-13 |
| 1730276486 | Robert Tan Ang | Psychiatry & Neurology | 3156 Willowcreek Road, Portage, IN 46368 | 2006-10-06 |
| 1013029883 | Primary Care PC | Family Medicine | 3125 Willowcreek Road, Portage, IN 46368 | 2006-08-31 |
| 1104936962 | Margaret Eileen Griffith | Dentist | 2646 Lois Street, Portage, IN 46368 | 2006-08-30 |
| Find all providers in zip 46368 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609498914 | David P Perrodin | Speech-Language Pathologist | 450 Winnebago Ave, Portage, WI 53901-1230 | 2020-05-08 |
| 1821466269 | Carissa Kostan | Speech-Language Pathologist | 130 Fowler Ln, Portage, PA 15946-7112 | 2015-09-02 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1386947786 | Kortnee Paige Moore Warner | Speech-Language Pathologist | N328 3rd Ave, Portage, WI 53901-9314 | 2010-12-08 |
| 1871731075 | Christine L. Porter | Speech-Language Pathologist | 7507 Woodbridge Lane, Portage, MI 49024-4097 | 2009-01-26 |
| 1639328867 | Casey Jo Ambort | Speech-Language Pathologist | 626 East Slifer St, Portage, WI 53901 | 2008-09-11 |
| 1699953976 | Lana Marie Edwards | Speech-Language Pathologist | 626 East Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1417149063 | Cassandra K Ringer | Speech-Language Pathologist | 7021 Elaine Ave, Portage, IN 46368-2611 | 2007-08-16 |
| 1811019961 | Adelia M Vanmeter | Speech-Language Pathologist | 8120 Moorsbridge, Portage, MI 49024-5344 | 2007-04-06 |
| 1770601247 | Marcie A. Kovalsky | Speech-Language Pathologist | 514 Orchard Street, Portage, PA 15946 | 2007-03-26 |
| Find all providers in PORTAGE | ||||
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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.