DR. TAVEEPONG TERAYANONT (NPI# 1427087188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427087188 |
| Entity Type | Individual |
| Full Name | DR. TAVEEPONG TERAYANONT |
| Credential | MD |
| Practice Address |
3700 Washington Ave Evansville IN 47714-0541 |
| Mailing Address |
Po Box 13059 Belfast ME 04915-4021 |
| Practice Telephone | 8124854994 |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2017-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
01056221A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEN PIN# | 000000326790 | 01 |
| IN | 200474390 | 05 | |
| IN | 100180890B | 05 |
| Street Address |
3700 WASHINGTON AVE |
| City | EVANSVILLE |
| State | IN |
| Zip Code | 47714-0541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972509115 | Teresa M. Brown | Obstetrics & Gynecology | 3700 Washington Ave, Ste 2200, Evansville, IN 47714-0541 | 2005-06-22 |
| 1003417064 | Kelli Robertson | Dietitian, Registered | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-11-05 |
| 1700409323 | Madeline Eisenhut | Pharmacist | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-05-19 |
| 1023647872 | Alexa Raenae Antrim | Physician Assistant | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-04-03 |
| 1104452077 | Swetha Chenna | Student in an Organized Health Care Education/Training Program | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-03-23 |
| 1902432883 | Jacob Konrad Weinzapfel | Student in an Organized Health Care Education/Training Program | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-03-23 |
| 1235765272 | Troy Manz | Student in an Organized Health Care Education/Training Program | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-03-22 |
| 1740816784 | Christopher C Shrack | Student in an Organized Health Care Education/Training Program | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-03-22 |
| 1245866185 | Neil Patrick Corbett | Student in an Organized Health Care Education/Training Program | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-03-22 |
| 1225664253 | Kengo Zaven Soghoyan | Student in an Organized Health Care Education/Training Program | 3700 Washington Ave, Evansville, IN 47714-0541 | 2020-03-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922343490 | Mary Elizabeth Esche | Physical Therapist | 3701 Bellemead Ave, Evansville, IN 47714 | 2012-12-10 |
| 1346524006 | Cheryl Ann Blanford | Pharmacist | 2015 E Covert Ave, Evansville, IN 47714 | 2011-09-29 |
| 1235446014 | Angela Kay Bradford-heidorn | Counselor | 4601 Bayard Park Drive, Evansville, IN 47714 | 2010-09-01 |
| 1104131655 | Cynthia D Lewis | Nurse Practitioner | 3700 Washington Ave Ste 202, Evansville, IN 47714 | 2010-08-09 |
| 1033357363 | Sarah M Voelkel | Podiatrist | 3801 Bellemeade Ave Ste 110a, Evansville, IN 47714 | 2009-01-23 |
| 1346443892 | Shilpa D Gaitonde | Internal Medicine | 3801 Bellemeade Ave Ste 300, Evansville, IN 47714 | 2007-06-11 |
| 1437361516 | Oncology Hematology Associates of Southwest Indiana | Internal Medicine | 3801 Bellemeade Suite 110, Evansville, IN 47714 | 2007-05-03 |
| 1629105374 | Comprehensive Neurosurgical Specialists, LLC | Neurological Surgery | 801 St Mary's Drive, Suite 505 East, Evansville, IN 47714 | 2007-02-28 |
| 1447387949 | Emily Mills | Physical Therapy Assistant | 1800 Elmendorf Avenue, Evanville, IN 47714 | 2007-02-28 |
| 1023153194 | Glen Gilbert Millikan II | Pharmacist | 1550 S. Vann Ave, Evansville, IN 47714 | 2007-02-20 |
| Find all providers in zip 47714 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962496661 | Susanna R Burkhead | Pediatrics | 3700 Washington Avenue, Evansville, IN 47750-0001 | 2005-09-08 |
| 1922193184 | Reuben Cohen | Pediatrics | 600 Mary St, Evansville, IN 47747-0001 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619219995 | Casey Kathleen Mccluskey | Pediatrics | 705 Riley Hospital Dr Rm 5867, Pediatric Residency Program Indiana University Som, Indianapolis, IN 46202-5109 | 2013-03-25 |
| 1225169196 | Pediatric Pulmonary & Critical Care, PC | Pediatrics | 7910 West Jefferson Blvd., Ste 205, Fort Wayne, IN 46804-4159 | 2007-03-09 |
| 1023198926 | Pediatric Specialty Physicians, PC | Pediatrics | 7429 Inverness Commons, Fort Wayne, IN 46804-3837 | 2006-10-16 |
| 1336161868 | Chandrashekhar Yalamanchali | Pediatrics | 11123 Parkview Plaza Dr Ste 202, Fort Wayne, IN 46845-1707 | 2006-07-24 |
| 1467408237 | Beacon Medical Group, Inc. | Pediatrics | 615 N Michigan St Fl 5, South Bend, IN 46601 | 2006-05-25 |
| 1184012130 | Hari Rasad Gourabathini | Pediatrics | 615 N Michigan St Fl 5, South Bend, IN 46601-1033 | 2014-12-29 |
| 1396001194 | Michelle M Gombas | Pediatrics | 2001 W 86th St, Indianapolis, IN 46260-1902 | 2012-04-05 |
| 1972892958 | Patrick J Noonan | Pediatrics | 7950 W Jefferson Blvd Ste 210, Fort Wayne, IN 46804-4140 | 2011-03-30 |
| 1194954420 | Paul William Halczenko | Pediatrics | 2001 W 86th St, Indianapolis, IN 46260-1902 | 2009-07-08 |
| 1922213057 | Jiuann-huey Ivy Lin | Pediatrics | 705 Riley Hospital Dr, Rr 127, Indianapolis, IN 46202-5109 | 2007-05-11 |
| Find all providers with the same taxonomy | ||||
| City | EVANSVILLE |
| Zip Code | 47714 |
Please comment or provide details below to improve the information on DR. TAVEEPONG TERAYANONT.
| 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.