MOBILE MEDICAL PROVIDER INC (NPI# 1659768356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659768356 |
| Entity Type | Organization |
| Organization Name | MOBILE MEDICAL PROVIDER INC |
| Practice Address |
12045 Bodley Place Fishers IN 46037-3714 |
| Practice Telephone | 3175881039 |
| Practice Fax Number | 3174367002 |
| Mailing Telephone | 3175881039 |
| Mailing Fax Number | 3174367002 |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2020-08-14 |
| Authorized Official Name | MR. ADESHOLA ABDULWAHID AFOLABI (PRESIDENT/CEO) |
| Authorized Official Telephone | 3175881039 |
| Authorized Official Credential | NURSE PRACTITION |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QH0002X |
Family Medicine Specialization: Hospice and Palliative Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RH0002X |
Internal Medicine Specialization: Hospice and Palliative Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084H0002X |
Psychiatry & Neurology Specialization: Hospice and Palliative Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
28204676A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201176490 | 05 | |
| IN | ANTHEM | 000000826011 | 01 |
| IN | CAQH | 12544963 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | MOBILE MEDICAL PROVIDER INC. | 12045 Bodley Place, Fishers, IN 46037 |
| Street Address |
12045 BODLEY PLACE |
| City | FISHERS |
| State | IN |
| Zip Code | 46037-3714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659994200 | Lake Meadows Licensee LLC | Assisted Living Facility | 11570 E 126th Street, Fishers, IN 46037 | 2020-05-18 |
| 1861059818 | Fishers Specialty Surgery Center, LLC | Clinic/Center | 14300 E 138th St, Fishers, IN 46037 | 2019-05-24 |
| 1033776604 | Diane M Gianfagna-meils | Reflexologist | 9117 Thoreau Court, Fishers, IN 46037 | 2019-05-20 |
| 1649796830 | Heartland Medical, LLC | Durable Medical Equipment & Medical Supplies | 12289 Harvest Glen Blvd, Fishers, IN 46037 | 2017-08-18 |
| 1578098703 | Galaxy Healthcare Services LLC | Home Health | 12262 Steepleview Ct, Fishers, IN 46037 | 2017-04-25 |
| 1386980472 | Brenda Lynn Thompson | Counselor | 8880 Jaywick Dr Apt 206, Fishers, IN 46037 | 2012-12-18 |
| 1972887941 | Molly E Bruvold | Pharmacist | 13741 East 116th Street, Fishers, IN 46037 | 2011-10-07 |
| 1588970867 | Marie C. Holt, Dds | Dentist | 7862 E. 96th St., Fishers, IN 46037 | 2010-08-25 |
| 1114157815 | Francis Edward Mcaree Jr. | Obstetrics & Gynecology | 10907 300 Yd. Dr, Fishers, IN 46037 | 2009-07-16 |
| 1740433820 | Robert Gerald Klitzman | Orthopaedic Surgery | 13100 E. 136th St., Suite 2000, Fishers, IN 46037 | 2008-11-03 |
| Find all providers in zip 46037 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609407014 | Carissa Leann Firmand | Nurse Practitioner | 12375 Castlestone Dr, Fishers, IN 46037-3906 | 2020-02-04 |
| 1912444126 | Sarah J Lecount | Nurse Practitioner | 10995 Allisonville Rd Ste 102, Fishers, IN 46038-2617 | 2017-01-25 |
| 1528016912 | Kelly E Ward | Nurse Practitioner | 8300 E 96th St, Fishers, IN 46037-9795 | 2006-05-05 |
| 1053866921 | Amy Woebkenberg | Nurse Practitioner | 13121 Olio Rd Ste 300, Fishers, IN 46037 | 2016-08-22 |
| 1487007241 | Hillary B Risk | Nurse Practitioner | 13100 E 136th St, Suite 1200, Fishers, IN 46037-9417 | 2016-07-18 |
| 1477918639 | Melissa Lyn Franiak | Nurse Practitioner | 10412 Allisonville Rd, Suite 100, Fishers, IN 46038-2052 | 2015-12-15 |
| 1225408016 | Jennifer A Stern | Nurse Practitioner | 13100 E 136th St, Ste 3000, Fishers, IN 46037-9417 | 2015-10-06 |
| 1629419908 | Kerrie Rochelle Suits | Nurse Practitioner | 11521 Fishers Dr, Fishers, IN 46038-1860 | 2013-07-15 |
| 1528408028 | Tricia J. Stadler | Nurse Practitioner | 8890 E 116th St, Suite 300, Fishers, IN 46038-2820 | 2013-06-28 |
| 1154633261 | Marie J Pfoser | Nurse Practitioner | 8300 E 96th St, Fishers, IN 46037-9795 | 2010-07-06 |
| Find all providers in FISHERS | ||||
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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.