INNERVISION ADVANCED MEDICAL IMAGING CENTER, LLC (NPI# 1649543141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649543141 |
| Entity Type | Organization |
| Organization Name | INNERVISION ADVANCED MEDICAL IMAGING CENTER, LLC |
| Practice Address |
1411 S Creasy Lane Suite 130 Lafayette IN 47905-7433 |
| Mailing Address |
Po Box 4699 Lafayette IN 47903-4699 |
| Practice Telephone | 7654477447 |
| Practice Fax Number | 7654465317 |
| Mailing Telephone | 7654492732 |
| Mailing Fax Number | 7654465317 |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2012-02-14 |
| Authorized Official Name | MARTHA K MILLER (DIRECTOR OF BILLING) |
| Authorized Official Telephone | 7654465417 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians | ||
| Y | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | INNERVISION ADVANCED MEDICAL IMAGING CENTER, LLC | 1515 West Dragoon Trail, Mishawaka, IN 46544 |
| Street Address |
1411 S CREASY LANE SUITE 130 |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47905-7433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558685495 | Douglas D Kesler | Physician Assistant | 1411 S Creasy Lane, Suite 120, Lafayette, IN 47905-7433 | 2010-03-22 |
| 1841599297 | Jon E Newman | Specialist/Technologist, Other | 1411 S Creasy Lane, Suite 120, Lafayette, IN 47905-7433 | 2011-03-24 |
| 1396052353 | Ann L Mcpherson | Occupational Therapist | 1411 S Creasy Lane, Suite 100, Lafayette, IN 47905-7433 | 2010-09-10 |
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|---|---|---|---|---|
| 1538719893 | Elements Counseling LLC | Social Worker | 115 N. Farabee Drive, Lafayette, IN 47905 | 2019-09-18 |
| 1134596869 | Indiana Dental Sleep Therapy LLC | Dentist | 4921 Sr 26 E, Suite 300, Lafayette, IN 47905 | 2015-08-28 |
| 1255750899 | Emily S Miller | Physical Therapist | 1701 Creasy Ln, Lafayette, IN 47905 | 2014-04-10 |
| 1073876215 | Nathan Webster | Dentist | 1530 Kossuth St., Lafayette, IN 47905 | 2012-06-22 |
| 1578848370 | Mark Jin Kim | Pharmacist | 1801 South St., Lafayette, IN 47905 | 2011-10-13 |
| 1700177185 | Shannon Tawn Harris | Speech-Language Pathologist | 8900 Cobbler Lane, Lafayette, IN 47905 | 2011-04-20 |
| 1508164484 | David Thomas Beine | Specialist/Technologist | 1321 Unity Pl Ste A, Lafayette, IN 47905 | 2011-03-02 |
| 1447569538 | Deidre Dudley | Nurse Practitioner | 1701 S Creasy Ln Ste 1w93, Lafayette, IN 47905 | 2010-10-07 |
| 1548493067 | Unity Healthcare, LLC | Podiatrist | 750 Park East Blvd, Unit 4, Lafayette, IN 47905 | 2009-09-01 |
| 1073762969 | Lynette Marie Alexander | Nurse Practitioner | 5500 St Rd. 38 East, Lafayette, IN 47905 | 2008-09-16 |
| Find all providers in zip 47905 | ||||
| Taxonomy Code | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376591685 | Bradford M. Piatt | Radiology | 970 Dewing Ave Ste 100, Lafayette, CA 94549-4278 | 2006-05-05 |
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|---|---|---|---|---|
| 1003954884 | Board of Trustees of Welborn Clinic | Radiology | 401 N Richland Creek Dr, Princeton, IN 47670-3536 | 2007-02-02 |
| 1134178148 | Southlake Mri & Diagnostic Center LLC | Radiology | 108 E 90th Dr, Merrillville, IN 46410-7160 | 2006-05-08 |
| 1043269012 | Valparaiso Radiology Group, LLC | Radiology | 2411 Laporte Ave, Valparaiso, IN 46383-6914 | 2006-05-08 |
| 1801881255 | Howard Elvindo Wiarda | Radiology | 621 Memorial Dr Ste 312, South Bend, IN 46601 | 2005-09-13 |
| 1578557815 | Radiology, Inc | Radiology | 620 W Edison Rd, Suite 110, Mishawaka, IN 46545-2784 | 2005-09-01 |
| 1013363308 | Madison County Community Health Center | Radiology | 1547 Ohio Ave, Anderson, IN 46016-1917 | 2016-05-05 |
| 1205190147 | Jonathan C Lee | Radiology | 5001 Us Highway 30 W Ste D, Fort Wayne, IN 46818-9701 | 2012-06-26 |
| 1740506229 | Sridevi Kanuri | Radiology | 620 W Edison Rd, Ste 110, Mishawaka, IN 46545-2784 | 2010-04-09 |
| 1417155169 | April L Cox | Radiology | 520 S 7th St, Vincennes, IN 47591-1038 | 2007-07-04 |
| 1164639985 | Durga K Pai | Radiology | 2401 W University Ave, Muncie, IN 47303-3428 | 2007-05-17 |
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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.