PRIMEHEALTH OF INDIANA LLC (NPI# 1609329093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609329093 |
| Entity Type | Organization |
| Organization Name | PRIMEHEALTH OF INDIANA LLC |
| Practice Address |
3815 River Crossing Pkwy Ste 100 Indianapolis IN 46240-7766 |
| Mailing Address |
2100 E Lake Cook Rd Ste 1000 Buffalo Grove IL 60089-1999 |
| Practice Telephone | 8448823127 |
| Mailing Telephone | 8848823127 |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2018-05-15 |
| Authorized Official Name | KENNETH KING (OWNER) |
| Authorized Official Telephone | 8448823127 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | Dental Providers | ||
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| N | 231H00000X | Audiologist | Speech, Language and Hearing Service Providers | ||
| Y | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers |
| Street Address |
3815 RIVER CROSSING PKWY STE 100 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46240-7766 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093884017 | Andre Lanard Durden | Physical Therapist | 3815 River Crossing Pkwy Ste 100, Indianapolis, IN 46240-7766 | 2006-11-06 |
| 1225645773 | Heather Allred | Nurse Practitioner | 3815 River Crossing Pkwy Ste 100, Indianapolis, IN 46240-7766 | 2020-09-29 |
| 1174130611 | Katherine Edney Watson | Nurse Practitioner | 3815 River Crossing Pkwy Ste 100, Indianapolis, IN 46240-7766 | 2020-09-29 |
| 1336753003 | Andrew Pingel | Physical Therapist | 3815 River Crossing Pkwy Ste 100, Indianapolis, IN 46240-7766 | 2020-09-01 |
| 1538772306 | Sikholisile Nyoni | Nurse Practitioner | 3815 River Crossing Pkwy Ste 100, Indianapolis, IN 46240-7766 | 2020-08-31 |
| 1336758937 | Transcending Path, LLC | Clinic/Center | 3815 River Crossing Pkwy Ste 100, Indianapolis, IN 46240-7766 | 2020-07-29 |
| 1821607862 | Atlas Therapy | Counselor | 3815 River Crossing Pkwy Ste 100, Indianapolis, IN 46240-7766 | 2020-07-27 |
| 1124640503 | Caremore Health Medical Partners, PC | Social Worker | 3815 River Crossing Pkwy Ste 100, Indianapolis, IN 46240-7766 | 2020-05-08 |
| 1760003784 | Shantrece N Davis | Nurse Practitioner | 3815 River Crossing Pkwy Ste 100, Indianapolis, IN 46240-7766 | 2020-04-30 |
| 1346874153 | Haley Wright | Occupational Therapist | 3815 River Crossing Pkwy Ste 100, Indianapolis, IN 46240-7766 | 2020-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124674908 | Indianapolis Neurobehavioral Health Center LLC | Psychologist | 921 E. 86th St., Suite 210 C, Indianapolis, IN 46240 | 2019-08-16 |
| 1720507999 | Refractive Surgery Professionals LLC | Clinic/Center | 8500 Keystone Xing Ste 150, Indianapolis, IN 46240 | 2017-09-19 |
| 1184148892 | Hannah Hoyt | Specialist/Technologist | 9504 N. Washington Blvd, Indianapolis, IN 46240 | 2017-08-03 |
| 1134657455 | Donann Kissick | Speech-Language Pathologist | 450 E 96th St., Suite 500, Indianapolis, IN 46240 | 2017-05-31 |
| 1992138804 | George Byington Pratt IIi | Radiology | 9015 Crystal Lake Drive, Indianapolis, IN 46240 | 2013-08-14 |
| 1871934513 | Kayla Harpenau | Occupational Therapist | 7405 Westfield Blvd, Indianapolis, IN 46240 | 2013-07-10 |
| 1235483835 | Christina Marie Wilson | Nurse Practitioner | 8888 Keystone Crossing, Suite 1300, Indianapolis, IN 46240 | 2012-11-04 |
| 1770850927 | Holly Bergeron | Pharmacist | 1505 E 86th Street, Indianapolis, IN 46240 | 2011-11-16 |
| 1104128214 | Meghan Kyle Fricke | Physician Assistant | 860 E 86th St Ste 4, Indianapolis, IN 46240 | 2010-11-22 |
| 1689901118 | Katherine Jane Russell | Audiologist | 2001 W. 86th St., Indianapolis, IN 46240 | 2009-11-04 |
| Find all providers in zip 46240 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194107607 | Mark Wavrunek | Podiatrist | 161 Washington Pointe Dr, Indianapolis, IN 46229-2693 | 2015-06-19 |
| 1639300486 | Paul M Kanter | Podiatrist | 348 Woodrow Ave, Indianapolis, IN 46241-0828 | 2009-07-28 |
| 1629208103 | Kenneth P Stumpf | Podiatrist | 6626 E 75th St, Ste 500, Indianapolis, IN 46250-2805 | 2009-07-20 |
| 1992960124 | Eugenia C Malenkos | Podiatrist | 1410 West 10th Street, Indianapolis, IN 46202-1616 | 2008-07-28 |
| 1740457555 | Lake Mi Mobile Doctors, P.C. | Podiatrist | 3388 Founders Rd, Suite C, Indianapolis, IN 46268-1443 | 2008-05-12 |
| 1093988263 | Jeremy Patrick Spaulding | Podiatrist | 8128 E Washington St, Indianapolis, IN 46219-6814 | 2008-04-09 |
| 1306018767 | Robert S. Mandresh Dpm PC Inc | Podiatrist | 8330 Naab Rd Ste 135, Indianapolis, IN 46260-1932 | 2008-03-26 |
| 1285837773 | Beech Grove Foot Care Inc | Podiatrist | 7855 S. Emerson Ave, Suite T, Indianapolis, IN 46237 | 2007-06-11 |
| 1366589467 | Indianapolis Osteopathic Hospital Inc. | Podiatrist | 3520 Guion Rd Suite 204, Indianapolis, IN 46222 | 2007-01-30 |
| 1447329826 | Thomas Wayne Zunica | Podiatrist | 3901 Meadows Dr, Indianapolis, IN 46205-3113 | 2006-11-07 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46240 |
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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.