JEFFERSON LAKE EMERGENCY PHYSICIANS LLC (NPI# 1649608795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649608795 |
| Entity Type | Organization |
| Organization Name | JEFFERSON LAKE EMERGENCY PHYSICIANS LLC |
| Practice Address |
1373 E State Road 62 Madison IN 47250-7328 |
| Mailing Address |
Po Box 37979 Philadelphia PA 19101-0579 |
| Practice Telephone | 8128010800 |
| Mailing Telephone | 9548382371 |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2019-08-29 |
| Authorized Official Name | KATHLEEN KONDAS (OFFICER) |
| Authorized Official Telephone | 9548382371 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
1373 E STATE ROAD 62 |
| City | MADISON |
| State | IN |
| Zip Code | 47250-7328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457341281 | George L. Alcorn | Internal Medicine | 1373 E State Road 62, Madison, IN 47250 | 2005-10-24 |
| 1538628714 | Lisa Christine Blevens | Nurse Practitioner | 1373 E State Road 62, Madison, IN 47250-7328 | 2019-03-18 |
| 1194256933 | Corey Michael Foster | Internal Medicine | 1373 E State Road 62, Madison, IN 47250-7328 | 2017-03-23 |
| 1437508033 | Kimberly Elisa Hall | Registered Nurse | 1373 E State Road 62, Madison, IN 47250-7328 | 2016-06-06 |
| 1548680812 | Daniel Long | Nurse Practitioner | 1373 E State Road 62, Madison, IN 47250-7328 | 2014-04-24 |
| 1942549464 | The Bethany Circle of Kings Daughters of Madison Indiana Inc | Durable Medical Equipment & Medical Supplies | 1373 E State Road 62, Madison, IN 47250-7328 | 2013-02-04 |
| 1497024426 | The Bethany Circle of Kings Daughters of Madison Indiana Inc | Clinical Medical Laboratory | 1373 E State Road 62, Madison, IN 47250-7328 | 2011-12-20 |
| 1598094252 | Charity Hope Welch | Nurse Practitioner | 1373 E State Road 62, Madison, IN 47250-7328 | 2009-12-09 |
| 1891855045 | The Bethany Circle of Kings Daughters of Madison Indiana Inc | Ambulance | 1373 E State Road 62, Madison, IN 47250-7328 | 2006-12-11 |
| 1235164625 | Michael J Schmidt | Radiology | 1373 E State Road 62, Madison, IN 47250 | 2006-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770196842 | Ariel C Breaux | Psychologist | 800 Bus Stop Dr, Madison, IN 47250 | 2020-08-28 |
| 1801314455 | Physicians Medical Center LLC | Nurse Practitioner | 311 E Clifty Drive, Madison, IN 47250 | 2017-09-05 |
| 1205201381 | Harrison County Hospital | Skilled Nursing Facility | 120 Presbyterian Avenue, Madison, IN 47250 | 2015-12-01 |
| 1720425796 | Kellie Robinson | Physical Therapist | 112 Holt Dr., Madison, IN 47250 | 2013-05-30 |
| 1568761575 | Linda Wehner D.m.d. LLC | Dentist | 1105 Clifty Drive, Madison, IN 47250 | 2011-03-17 |
| 1205142221 | Mary-caroline Peddie | Registered Nurse | 2003 Hycliff Ct, Madison, IN 47250 | 2010-08-27 |
| 1235376625 | Brian Edward Armbrecht | Pharmacist | One King's Daughters' Dr, Madison, IN 47250 | 2009-01-07 |
| 1902092661 | Assisted Living Concepts Inc | Assisted Living Facility | 607 Virginia Avenue, Madison, IN 47250 | 2007-09-17 |
| 1831218262 | Voca of Indiana LLC | Intermediate Care Facility, Mentally Retarded | 3004 Kentucky Ave, Madison, IN 47250 | 2007-03-28 |
| 1396877205 | Quinco Consulting Center Inc | Clinic/Center | 3100 N Bevcher Drive, Madison, IN 47250 | 2007-03-09 |
| Find all providers in zip 47250 | ||||
| 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 |
|---|---|---|---|---|
| 1114375367 | Arthur How Jen Chiu | Emergency Medicine | 1726 Chadbourne Ave, Madison, WI 53726-4108 | 2016-05-28 |
| 1164802138 | Adam Nicholson | Emergency Medicine | 600 Highlanc Ave, Madison, WI 53792-0001 | 2015-06-04 |
| 1043606841 | Kevin P Emmerich | Emergency Medicine | 390 West Johnson St, Madison, WI 53703 | 2015-04-09 |
| 1083004360 | Lauren M Sheehy | Emergency Medicine | 2715 Marshall Ct Apt 216, Madison, WI 53705-2240 | 2015-01-26 |
| 1720347941 | Hannah Eason Bates | Emergency Medicine | 107 Waterford Cir, Madison, AL 35758-7847 | 2012-05-08 |
| 1457649634 | Nicholas R Conwell | Emergency Medicine | 4142 Veith Ave, Madison, WI 53704-1149 | 2011-07-21 |
| 1720376015 | James G Berbee | Emergency Medicine | 3534 Lake Mendota Dr, Madison, WI 53705-1473 | 2011-07-20 |
| 1134418486 | Matthew Lochen | Emergency Medicine | 700 S. Park Street, Department of Emergency Medicine, Madison, WI 53715 | 2011-04-06 |
| 1548493588 | Theresa Kinney Payant Mckenna | Emergency Medicine | 3033 Irvington Way, Madison, WI 53713-3413 | 2009-08-25 |
| 1992967343 | Jamie Michelle Hess | Emergency Medicine | 800 University Bay Dr, Suite 310, Madison, WI 53705-2278 | 2008-06-26 |
| Find all providers in MADISON | ||||
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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.