MR. ADAM GENTRY DETIG (NPI# 1629604939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629604939 |
| Entity Type | Individual |
| Full Name | MR. ADAM GENTRY DETIG |
| Credential | PA-C |
| Practice Address |
5255 E Stop 11 Rd Ste 430 Indianapolis IN 46237-6341 |
| Mailing Address |
Po Box 781076 Detroit MI 48278-1076 |
| Practice Telephone | 3175281212 |
| Mailing Telephone | 3175284800 |
| Enumeration Date | 2020-03-18 |
| Last Update Date | 2020-04-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 10002938A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1542 S Bloomington St, Greencastle, IN 461352212 | 3175281212 | 3175281252 |
| 2451 Intelliplex Dr # 3, Shelbyville, IN 461768580 | 3175282674 | 3175281252 |
| Street Address |
5255 E STOP 11 RD STE 430 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46237-6341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942269287 | Jason D Brown | Physician Assistant | 5255 E Stop 11 Rd Ste 430, Indianapolis, IN 46237-6341 | 2006-03-23 |
| 1649802810 | Sarah Kristine Williams | Physician Assistant | 5255 E Stop 11 Rd Ste 430, Indianapolis, IN 46237-6341 | 2020-02-06 |
| 1407014657 | Brian Michael Rapp | Surgery | 5255 E Stop 11 Rd Ste 430, Indianapolis, IN 46237-6341 | 2008-05-23 |
| 1558380931 | Robert Alan Mccready | Surgery | 5255 E Stop 11 Rd Ste 430, Indianapolis, IN 46237-6341 | 2006-07-18 |
| 1326086646 | Lori Kemper | Surgery | 5255 E Stop 11 Rd Ste 430, Indianapolis, IN 46237-6341 | 2006-06-02 |
| 1861455156 | Charles Steven Kiell | Surgery | 5255 E Stop 11 Rd Ste 430, Indianapolis, IN 46237-6341 | 2006-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568961902 | Ashley Marie Mitchell | Nurse Practitioner | 8111 S Emerson Ave # 101, Indianapolis, IN 46237 | 2018-02-11 |
| 1245692177 | Christopher W Gregory | Pharmacist | 8111 S Emerson Avenue, Indianapolis, IN 46237 | 2016-03-21 |
| 1558729111 | Franklin Point Dental | Clinic/Center | 6751 E Southport Rd, Suite H, Indianapolis, IN 46237 | 2016-02-10 |
| 1821460767 | Costco Wholesale Corporation | Pharmacy | 4628 E County Line Rd, Indianapolis, IN 46237 | 2015-10-29 |
| 1164894697 | Mercedes Castellanos-pitcock | Physician Assistant | 7855 S Emerson Ave Ste P, Indianapolis, IN 46237 | 2015-10-23 |
| 1013301142 | Sophia Frawley | Physical Therapist | 7855 South Emerson Avenue, Suite W, Indianepolis, IN 46237 | 2015-03-26 |
| 1154715829 | Emily Marie Prather | Specialist/Technologist | 4607 Citation Cir, Indianapolis, IN 46237 | 2015-03-20 |
| 1659794543 | Rachel Adams | Occupational Therapy Assistant | 6525 Moss Creek Place, Indianapolis, IN 46237 | 2014-01-28 |
| 1790121549 | Carol Lynn Patton | Nurse Practitioner | 8111 S Emerson Ave Fl 5, Indianapolis, IN 46237 | 2013-05-21 |
| 1255685772 | Jarron J Lincoln | Physician Assistant | 5230 E Stop 11 Rd Ste 250, Indianapolis, IN 46237 | 2012-11-06 |
| Find all providers in zip 46237 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779739 | Brock Sokolowski | Physician Assistant | 4581 Nikki Dr Apt D, Indianapolis, IN 46237-1703 | 2020-10-28 |
| 1699373357 | Dillon Etter | Physician Assistant | 2848 N Delaware St, Indianapolis, IN 46205-4118 | 2020-10-15 |
| 1962017210 | Taylor Lee Bowen | Physician Assistant | 2760 Woodwind Way, Indianapolis, IN 46268-4233 | 2020-09-14 |
| 1912512476 | William Terrell Parmenter | Physician Assistant | 2230 English Ave, Indianapolis, IN 46201-4017 | 2020-09-11 |
| 1457966376 | Angela Shearon | Physician Assistant | 4325 N College Ave, Indianapolis, IN 46205-1931 | 2020-09-09 |
| 1639797004 | John Padraic Allbritton | Physician Assistant | 9339 Notre Dame Dr Apt D, Indianapolis, IN 46240-4168 | 2020-07-11 |
| 1154949907 | Jonathon Michael Hirsch | Physician Assistant | 5801 N Olney St Apt 9, Indianapolis, IN 46220-5181 | 2020-07-08 |
| 1437776838 | Megan Leanna Reynolds | Physician Assistant | 3841 Rookwood Ave, Indianapolis, IN 46208-3926 | 2020-07-01 |
| 1669099412 | Alisa Elaine Schrump | Physician Assistant | 7618 Old Hickory Ct, Indianapolis, IN 46259-9575 | 2020-06-28 |
| 1144846148 | Melanie M. Herrold | Physician Assistant | 5255 E Stop 11 Rd Ste 200, Indianapolis, IN 46237-6341 | 2020-06-25 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46237 |
Please comment or provide details below to improve the information on MR. ADAM GENTRY DETIG.
| 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.