ST CATHERINE PHYSICIAN SERVICES, LLC (NPI# 1639352610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639352610 |
| Entity Type | Organization |
| Organization Name | ST CATHERINE PHYSICIAN SERVICES, LLC |
| Other Organization Name | SAINT CATHERINE MEDICAL GROUP, MSO |
| Practice Address |
2100 Market St. Suite 100 Charlestown IN 47111-9535 |
| Practice Telephone | 8122569714 |
| Practice Fax Number | 8122569702 |
| Mailing Telephone | 8122569714 |
| Mailing Fax Number | 8122569702 |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2012-06-20 |
| Authorized Official Name | MS. ROSIE M. TAULBEE (PHYSICIAN PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 8122567436 |
| Is Organization Subpart | Y |
| Parent Organization Name | SAINT CATHERINE PHYSICIANS SERVICES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
01028535A | IN | Allopathic & Osteopathic Physicians |
| Y | 207P00000X | Emergency Medicine | 01027298A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | UPIN | B28860 | 01 |
| IN | ANTHEM BC/BS | 000000549974 | 01 |
| Other Name | Type Code |
|---|---|
| Saint Catherine Medical Group, MSO | Doing Business As Name - Organization |
| Street Address |
2100 MARKET ST. SUITE 100 |
| City | CHARLESTOWN |
| State | IN |
| Zip Code | 47111-9535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790973030 | Saint Catherine Physicians Services LLC | Nurse Practitioner | 2100 Market St., Charlestown, IN 47111 | 2007-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003275488 | Janet Hilderbrand | Counselor | 7509 Charleston Pike, Charleston, IN 47111 | 2016-02-15 |
| 1891117784 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 2400 Market Street, Charlestown, IN 47111 | 2014-01-10 |
| 1497996466 | Rivercrossing Independent and Assisted Living Community | Assisted Living Facility | 2400 West Market Street, Charlestown, IN 47111 | 2009-03-20 |
| 1962628990 | Travis Lee Gross | Dentist | 9419 State Road 403, Charlestown, IN 47111 | 2007-04-18 |
| 1366585572 | William H Garner IIi | Surgery | 2100 Market Street, Charlestown, IN 47111 | 2007-02-15 |
| 1871603803 | Gary E Smith | Dentist | 1417 Market St, Charlestown, IN 47111 | 2006-08-31 |
| 1841239464 | Jennifer S Kramp | Physical Therapist | 9407 County Rd 403, Charlestown, IN 47111 | 2006-06-06 |
| 1861472169 | Michael Patrick Hensley | Physical Therapist | 9407 Highway 403, Charlestown, IN 47111 | 2006-01-20 |
| 1598289183 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 9616 County Road 403, Charlestown, IN 47111 | 2017-07-26 |
| 1518406099 | Connie King | Counselor | 7509 Charlestown Pike, Charlestown, IN 47111 | 2017-02-17 |
| Find all providers in zip 47111 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619963105 | Joseph Herman Beaven | Emergency Medicine | 9431 County Road 403, Charlestown, IN 47111-8946 | 2005-09-21 |
| 1750613485 | Indiana Emergency Physicians LLP | Emergency Medicine | 2200 Market Street, Charlestown, IN 47111-0069 | 2010-02-05 |
| 1154470052 | Peony Emergency Physicians | Emergency Medicine | 2200 Market St, Charlestown, IN 47111-9553 | 2007-01-09 |
| 1215031869 | Clark Emergenc Y Group, LLC | Emergency Medicine | 2200 Market St, Charlestown, IN 47111-9553 | 2006-09-12 |
| 1659320885 | Ramesh Chandra Sharma | Emergency Medicine | 2200 Market St, Saint Catherine Regional Hospital, Charlestown, IN 47111 | 2006-05-06 |
| 1093797904 | Piayon Kobbah | Emergency Medicine | 4602 Maccorkle Ave Se, Charlestown, WV 25304 | 2005-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396358255 | Vyvian Charlene Lawrence | Emergency Medicine | 5939 W Lincoln Hwy, Crown Point, IN 46307-9604 | 2020-08-28 |
| 1508358128 | Antonino Bucca | Emergency Medicine | 720 Eskenazi Ave Bldg 3, Indianapolis, IN 46202-5187 | 2018-05-30 |
| 1124518931 | Evan Mitchell Landry Tomkiewicz | Emergency Medicine | 720 Eskenazi Ave Fl Ft3, Indianapolis, IN 46202-5187 | 2018-05-16 |
| 1760907299 | Timothy John Howard | Emergency Medicine | 610 1/2 N Main Street, Apartment 1, Mishawaka, IN 46545 | 2017-08-05 |
| 1760913891 | Nathan Francis Marcinkowski | Emergency Medicine | 216 N 4th St Ste 205, Lafayette, IN 47901-1323 | 2017-03-21 |
| 1154777613 | Michael J Bojrab | Emergency Medicine | 6720 Kirkdale Dr, Fort Wayne, IN 46815-5524 | 2016-05-13 |
| 1114307063 | Grant Fabian Chernoby | Emergency Medicine | 701 N Senate Ave # B401, Indianapolis, IN 46202-3111 | 2015-06-05 |
| 1457730830 | Patrick Lee Studtman | Emergency Medicine | 615 N. Michigan Street, Emergency Department, South Bend, IN 46601-1033 | 2015-05-19 |
| 1861888430 | Enola Okonkwo | Emergency Medicine | 9785 Valley Springs Blvd, Fishers, IN 46037-8764 | 2015-04-10 |
| 1518355882 | Marlin R. Gray | Emergency Medicine | 925 N. County Rd., 1100e, Otwell, IN 47564 | 2015-01-08 |
| Find all providers with the same taxonomy | ||||
| City | CHARLESTOWN |
| Zip Code | 47111 |
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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.