VASCULAR SURGERY OF KOKOMO, PC (NPI# 1497702013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497702013 |
| Entity Type | Organization |
| Organization Name | VASCULAR SURGERY OF KOKOMO, PC |
| Practice Address |
305 S Berkley Rd Kokomo IN 46901-5114 |
| Practice Telephone | 7652368750 |
| Practice Fax Number | 7652368760 |
| Mailing Telephone | 7652368750 |
| Mailing Fax Number | 7652368760 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2013-05-28 |
| Authorized Official Name | CRAIG A MILLER (PHYSICIAN) |
| Authorized Official Telephone | 7652368750 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
01058152A | IN | Allopathic & Osteopathic Physicians |
| Street Address |
305 S BERKLEY RD |
| City | KOKOMO |
| State | IN |
| Zip Code | 46901-5114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871046508 | Kelly Janowski | Nurse Practitioner | 305 S Berkley Rd, Kokomo, IN 46901-5114 | 2016-07-29 |
| 1750600383 | Danielle Nicole Campbell | Surgery | 305 S Berkley Rd, Kokomo, IN 46901-5114 | 2010-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607597 | Momentum Kokomo, LLC | Substance Abuse Rehabilitation Facility | 1236 N. Wabash Ave, Kokomo, IN 46901 | 2020-10-23 |
| 1457826869 | Jodi Gayle Lake | Developmental Therapist | 2523 Lorentson Ct, Kokomo, IN 46901 | 2018-10-11 |
| 1871088369 | Hope Behavioral Servies, LLC | Behavioral Analyst | 924 Clark St, Kokomo, IN 46901 | 2018-06-27 |
| 1255782306 | Forefront Dermatology, S.c. | Dermatology | 2130 W Sycamore St Ste 200, Kokomo, IN 46901 | 2016-06-29 |
| 1164860706 | Renee Michelle Brown | Registered Nurse | 2776 Amberwood Place, Kokomo, IN 46901 | 2013-06-05 |
| 1063642916 | Michelle K Rush | Speech-Language Pathologist | 2532 Lauren Ln, Kokomo, IN 46901 | 2009-07-24 |
| 1396957189 | Lifetime Dental Care of In, PC | Dentist | 927 S Washington St, Kokomo, IN 46901 | 2007-05-04 |
| 1245458355 | Wagoner Medical Center, LLC | Internal Medicine | 2016 W Sycamore, Kokomo, IN 46901 | 2007-04-23 |
| 1053442723 | Jesusa Salhieh | Contractor | Genesis Rehab Bloom, Kokomo, IN 46901 | 2007-03-07 |
| 1740382928 | Donald A Fantuzzo Dds PC | Dentist | 2196 W Sycamore St, Kokomo, IN 46901 | 2006-09-01 |
| Find all providers in zip 46901 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750600383 | Danielle Nicole Campbell | Surgery | 305 S Berkley Rd, Kokomo, IN 46901-5114 | 2010-05-21 |
| 1881737724 | Mayda Vascular, Inc. | Surgery | 3611 S Reed Rd, Suite 105, Kokomo, IN 46902-3828 | 2007-02-14 |
| 1326104993 | Jaro Mayda II | Surgery | 3611 S Reed Rd, 105, Kokomo, IN 46902-3806 | 2006-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801456603 | Wickel Vascular Surgery & Medicine PC | Surgery | 1919 State St Ste 444, New Albany, IN 47150-6809 | 2019-06-14 |
| 1154832178 | Allied Physicians of Michiana, LLC | Surgery | 611 E Douglas Rd Ste 308, Mishawaka, IN 46545-1465 | 2017-10-17 |
| 1194041764 | Andrew Alexander Gonzalez | Surgery | 1801 N Senate Blvd Ste 3500, Indianapolis, IN 46202-1184 | 2010-04-08 |
| 1649468364 | South Bend Vein Center for Excelllence, LLC | Surgery | 2025 Edison Rd, South Bend, IN 46637-5599 | 2007-10-09 |
| 1396938031 | Peripheral Vascular Care | Surgery | 640 S Walker St, Bloomington, IN 47403-2158 | 2007-08-27 |
| 1285841502 | Decatur Vein Clinic Hobart, PC | Surgery | 5043 E Lincoln Hwy, Merrillville, IN 46410-5912 | 2007-05-17 |
| 1093881385 | Decatur Vein Clinic, Michigan, PC | Surgery | 645 W Carmel Dr, Suite 101, Carmel, IN 46032-2605 | 2006-11-28 |
| 1962508853 | Indiana Phlebology PC | Surgery | 371 E 84th Dr Ste 371, Merrillville, IN 46410-6484 | 2006-09-16 |
| 1447361928 | The Heart and Vascular Clinic, P.C. | Surgery | 3251 Shawnee Drive South, Bedford, IN 47421 | 2006-08-31 |
| 1487761607 | Abdolaziz M Ardalan | Surgery | 9737 Decatur Dr, Indianapolis, IN 46256-9656 | 2006-08-24 |
| Find all providers with the same taxonomy | ||||
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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.