MIDWEST PAIN INSTITUTE CENTER FOR MINIMALLY INVASIVE SPINE PC (NPI# 1659504108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659504108 |
| Entity Type | Organization |
| Organization Name | MIDWEST PAIN INSTITUTE CENTER FOR MINIMALLY INVASIVE SPINE PC |
| Practice Address |
1115 Ronald Reagan Pkwy Suite 235 Avon IN 46123-6910 |
| Practice Telephone | 3172723880 |
| Practice Fax Number | 3172729068 |
| Mailing Telephone | 3172723880 |
| Mailing Fax Number | 3172729068 |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2010-11-09 |
| Authorized Official Name | MRS. SONIA WISEMAN (BILLING MANAGER) |
| Authorized Official Telephone | 3172723880 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
50004309A | IN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982185641 | Midwest Pain Institute Center for Minimally Invasive Spine PC | Pain Medicine | 7301 N Shadeland Ave Ste 1a, Indianapolis, IN 46250-2085 | 2018-08-22 |
| 1518290048 | Midwest Pain Institute Center for Minimally Invasive Spine PC | Physical Medicine & Rehabilitation | 2302 S Dixon Rd, Suite 150, Kokomo, IN 46902-6424 | 2009-09-16 |
| 1497785273 | Midwest Pain Institute Center for Minimally Invasive Spine PC | Pain Medicine | 12289 Hancock St Ste 34, Carmel, IN 46032-5888 | 2006-07-04 |
| Street Address |
1115 RONALD REAGAN PKWY SUITE 235 |
| City | AVON |
| State | IN |
| Zip Code | 46123-6910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679573620 | James C Sloan | Urology | 1115 Ronald Reagan Pkwy, Ste 364, Avon, IN 46123-6910 | 2005-07-29 |
| 1487111274 | Ann Shackelford Reeves | Nurse Practitioner | 1115 Ronald Reagan Pkwy, Avon, IN 46123-6910 | 2019-02-27 |
| 1215412432 | Heather Renee Seaborne | Registered Nurse | 1115 Ronald Reagan Pkwy, Avon, IN 46123-6910 | 2018-10-03 |
| 1770959744 | Chelsea Durnil | Pharmacist | 1115 Ronald Reagan Pkwy, Ste 318, Avon, IN 46123-6910 | 2015-08-13 |
| 1578961314 | Urology of Indiana L.l. C. | Durable Medical Equipment & Medical Supplies | 1115 Ronald Reagan Pkwy, Suite 247, Avon, IN 46123-6910 | 2014-12-10 |
| 1639445315 | Thomas A Brady Sports Medicine Ctr | Durable Medical Equipment & Medical Supplies | 1115 Ronald Reagan Pkwy, Avon, IN 46123-6910 | 2012-03-28 |
| 1912290925 | Kyle Andrew Frick | Internal Medicine | 1115 Ronald Reagan Pkwy, Avon, IN 46123-6910 | 2011-05-24 |
| 1831405422 | Amanda N Crishon | Audiologist | 1115 Ronald Reagan Pkwy, Ste 225, Avon, IN 46123-6910 | 2010-08-20 |
| 1831410703 | Robert Neal Ingram | Registered Nurse | 1115 Ronald Reagan Pkwy, Pkwy 171, Avon, IN 46123-6910 | 2010-06-15 |
| 1316276363 | Indianapolis Neurosurgical Group | Nurse Practitioner | 1115 Ronald Reagan Pkwy, Suite 148, Avon, IN 46123-6910 | 2009-12-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669018669 | Dienye Williams | Pharmacist | 108 North Sr 267, Avon, IN 46123 | 2019-11-25 |
| 1992353817 | Debra Blackwell | Technician | 8198 Montage Ave, Apt 104, Avon, IN 46123 | 2019-09-04 |
| 1932675766 | Blake Ponist | Occupational Therapist | 10940 E U S Highway 36, Rockville Rd, Avon, IN 46123 | 2018-10-19 |
| 1396238150 | Sarah Sweany | Dietitian, Registered | Iu Health West Cancer Center, 1111 North Ronald Reagen Pkwy Suite B1600, Avon, IN 46123 | 2018-06-07 |
| 1124516257 | Sheree Itza | Counselor | 6655 E Us Highway 36 Ste 100, Avon, IN 46123 | 2018-04-24 |
| 1255860607 | Jonathan Lambert | Dentist | 110 N Avon Ave B, Avon, IN 46123 | 2017-06-08 |
| 1023546629 | 10439 E Us Highway 36 Dental, LLC | Dentist | 10439 E Us Highway 36, Avon, IN 46123 | 2017-05-25 |
| 1902330756 | Melissa Wheatley | Occupational Therapy Assistant | 6294 Forest View Court, Avon, IN 46123 | 2017-04-19 |
| 1932555844 | Gal Marcan | Family Medicine | 1351 Ronald Reagan Pkwy Ste B, Avon, IN 46123 | 2016-05-10 |
| 1962871301 | Annette Joelene Oechsle | Health Educator | 1820 South County Road 525 East, Avon, IN 46123 | 2015-09-16 |
| Find all providers in zip 46123 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932683471 | New Wellspring LLC | Physical Medicine & Rehabilitation | 2400 Northpark Dr Ste 20, Columbus, IN 47203-4467 | 2018-09-20 |
| 1003247008 | Advancd Pain and Rehab Md LLC | Physical Medicine & Rehabilitation | 1443 S Lake Park Ave, Hobart, IN 46342-6635 | 2013-12-02 |
| 1639454440 | Merrillville Pain Relief Center PC | Physical Medicine & Rehabilitation | One Tower Plaza, 111 E 89th Avenue, Ste 111, Merrillville, IN 46410-7184 | 2011-10-13 |
| 1639211808 | Joseph William Bergeron | Physical Medicine & Rehabilitation | 9292 N Meridian St Ste 111, Indianapolis, IN 46260-1828 | 2007-02-13 |
| 1861542565 | Ofelia Balagtas-balmaseda | Physical Medicine & Rehabilitation | 4812 S 7th St, Terre Haute, IN 47802-4502 | 2007-01-12 |
| 1548352727 | Choong Jin Yoon | Physical Medicine & Rehabilitation | 600 Saint Andrews Dr, Schererville, IN 46375-2970 | 2006-09-28 |
| 1669425419 | Heartland Physical Medicine & Rehabilitation PC | Physical Medicine & Rehabilitation | 1019 E Springhill Dr, Terre Haute, IN 47802 | 2006-05-19 |
| 1730130402 | Robert K Silbert | Physical Medicine & Rehabilitation | 6640 Parkdale Pl, Suite R, Indianapolis, IN 46254-5619 | 2006-05-15 |
| 1467423939 | Mark V Reecer | Physical Medicine & Rehabilitation | 5750 Coventry Ln, Suite 101, Fort Wayne, IN 46804-7166 | 2006-01-31 |
| 1295732055 | Steven A Rupert | Physical Medicine & Rehabilitation | 2330 Lynch Rd, Suite 100, Evansville, IN 47711-2998 | 2005-07-07 |
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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.