NORTHEAST INTERNAL MEDICINE (NPI# 1366859779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366859779 |
| Entity Type | Organization |
| Organization Name | NORTHEAST INTERNAL MEDICINE |
| Practice Address |
2500 N Detroit St Lagrange IN 46761-1158 |
| Mailing Address |
Po Box 236 Lagrange IN 46761-0236 |
| Practice Telephone | 2604632133 |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2019-02-27 |
| Authorized Official Name | TARA GILMORE (BUSINESS OFFICE MANAGER) |
| Authorized Official Telephone | 2604632133 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
71004993A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 610 N Sawyer Rd, Kendallville, IN 467552566 | 2603475592 | 2603475155 |
| Street Address |
2500 N DETROIT ST |
| City | LAGRANGE |
| State | IN |
| Zip Code | 46761-1158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174518500 | Northeast Internal Medicine Associates,p.c | Internal Medicine | 2500 N Detroit St, Lagrange, IN 46761-1158 | 2005-09-12 |
| 1447894639 | Taylor Abigail Smyth | Physician Assistant | 2500 N Detroit St, Lagrange, IN 46761-1158 | 2019-10-31 |
| 1821644659 | Heather Kaye Fox | Nurse Practitioner | 2500 N Detroit St, Lagrange, IN 46761-1158 | 2019-08-16 |
| 1700430527 | Brittney M Harmeyer | Nurse Practitioner | 2500 N Detroit St, Lagrange, IN 46761-1158 | 2019-07-30 |
| 1578054193 | Megan Marie Buuck | Nurse Practitioner | 2500 N Detroit St, Lagrange, IN 46761-1158 | 2018-05-21 |
| 1114449329 | Lauren Fiandt | Nurse Practitioner | 2500 N Detroit St, Lagrange, IN 46761-1158 | 2017-07-10 |
| 1073034500 | Amber N Handshoe | Nurse Practitioner | 2500 N Detroit St, Lagrange, IN 46761-1158 | 2017-07-06 |
| 1962941054 | Carole S Buchs | Nurse Practitioner | 2500 N Detroit St, Lagrange, IN 46761-1158 | 2017-02-22 |
| 1801249834 | Eleonor Vanover | Physician Assistant | 2500 N Detroit St, Lagrange, IN 46761-1158 | 2016-07-14 |
| 1861844037 | Courtney Boggs | Nurse Practitioner | 2500 N Detroit St, Lagrange, IN 46761-1158 | 2016-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962049007 | Darlene L. Schlotterback | Physical Therapist | 207 N. Townline Rd, Lagrange, IN 46761 | 2019-12-09 |
| 1083264006 | Kimberly A Hershberger | Pharmacist | 0975 N 00 Ew, Lagrange, IN 46761 | 2019-09-12 |
| 1134775554 | Kristy Jo Roth | Pharmacist | 0975n 00 Ew, Lagrange, IN 46761 | 2019-08-12 |
| 1235372277 | Lagrange Surgery Center, LLC | Clinic/Center | 2500 Ventura Way, Lagrange, IN 46761 | 2009-04-07 |
| 1568565265 | Hook Superx LLC | Pharmacy | 975n Ooew, Lagrange, IN 46761 | 2006-09-07 |
| 1558305326 | Craig L Nelson Dds Inc | Dentist | 405 Union Street, Lagrange, IN 46761 | 2006-06-15 |
| 1134184781 | Michael W Conway | Family Medicine | 207 N Townline Rd Ste 104, Lagrange, IN 46761 | 2006-04-18 |
| 1548220544 | Millard Reed Taylor | Family Medicine | 2120 N Detroit St, Lagrange, IN 46761 | 2006-03-24 |
| 1891791414 | Larry Best | Podiatrist | 400 1/2 Union Street, Lagrange, IN 46761 | 2005-06-28 |
| 1972140010 | Vickie L. Pletcher | Physical Therapy Assistant | 207 N. Townline Rd., Lagrange, IN 46761 | 2019-12-09 |
| Find all providers in zip 46761 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831740794 | Sandeep Kaur Singh | Nurse Practitioner | 1495 Lafayette Pkwy, Lagrange, GA 30241-2552 | 2019-09-23 |
| 1346538733 | Kelly Dianne Morgan | Nurse Practitioner | 1602 Vernon Rd, Suite 400, Lagrange, GA 30240-4129 | 2011-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942809140 | Indiana Suburban Visiting Physician Services | Nurse Practitioner | 5 Washington St Ste 300, Valparaiso, IN 46383-4769 | 2020-10-20 |
| 1033737069 | Housecalls/optum for United Health Group | Nurse Practitioner | 518 Euclid Ave, Greenwood, IN 46142-3618 | 2020-07-07 |
| 1497382030 | Toya Jamillah Woods | Nurse Practitioner | 3814 Grant St, Gary, IN 46408-2150 | 2020-03-24 |
| 1558905554 | Amy Hueston | Nurse Practitioner | 313 S Berkley Rd, Kokomo, IN 46901-5114 | 2019-11-01 |
| 1891338166 | Jayme Lantz | Nurse Practitioner | 20085 Turquoise Ln, Goshen, IN 46528-6294 | 2019-10-19 |
| 1033761770 | Workplace Health Services | Nurse Practitioner | 1632 W. In-28, Frankfort, IN 46041 | 2019-07-12 |
| 1164984597 | Care At Home LLC | Nurse Practitioner | 717 Washington Park Blvd, Michigan City, IN 46360-2056 | 2019-04-04 |
| 1255815379 | Amanda Kay Goins | Nurse Practitioner | 3919 W Jefferson Blvd Ste B, Fort Wayne, IN 46804-6811 | 2018-09-25 |
| 1972084267 | Kelly Sue Ann Peasley | Nurse Practitioner | 2101 Jackson St Ste 8, Anderson, IN 46016-4341 | 2018-08-24 |
| 1891271466 | Hilton Health Housecall LLC | Nurse Practitioner | 4340 Trace Wood Dr, Indianapolis, IN 46254-6238 | 2018-07-17 |
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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.