KAELY S BADE (NPI# 1689933103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689933103 |
| Entity Type | Individual |
| Full Name | KAELY S BADE |
| Credential | M.D. |
| Practice Address |
11104 Parkview Circle Dr Ste 310 Fort Wayne IN 46845-1733 |
| Mailing Address |
3702 New Vision Dr Bldg B Fort Wayne IN 46845-1703 |
| Practice Telephone | 2602665230 |
| Practice Fax Number | 2602665238 |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2019-08-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
01080216A | IN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 619 19th St S, Birmingham, AL 352491900 | 2059349666 |
| Street Address |
11104 PARKVIEW CIRCLE DR STE 310 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-1733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285633552 | Leor David Roubein | Internal Medicine | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1672 | 2005-07-19 |
| 1689280356 | Tabatha North | Registered Nurse | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1733 | 2020-09-18 |
| 1578128575 | Erin L Mctague | Physician Assistant | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1733 | 2019-05-06 |
| 1184187999 | Christina M Weiss | Registered Nurse | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1733 | 2019-04-09 |
| 1104389121 | Amanda R Follrod | Registered Nurse | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1733 | 2019-04-08 |
| 1629572094 | Taylor Pinney | Physician Assistant | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845 | 2018-03-21 |
| 1477055804 | Stacie Stauffer | Registered Nurse | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1733 | 2018-03-01 |
| 1053827469 | Megan E Daniels | Registered Nurse | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1733 | 2017-12-20 |
| 1649701996 | Martha Vergara | Nurse Practitioner | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1672 | 2017-03-27 |
| 1356897383 | Abby J Emerick | Nurse Practitioner | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1733 | 2016-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
| 1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
| 1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
| 1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
| Find all providers in zip 46845 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790137115 | Abdinoor Medical LLC | Internal Medicine | 1819 Braemar Dr, Fort Wayne, IN 46814-9364 | 2016-07-09 |
| 1902895949 | Imad E Horani | Internal Medicine | 2231 Carew St, Fort Wayne, IN 46805-4713 | 2005-10-20 |
| 1164411203 | Martin J Kaplan | Internal Medicine | 3439 Hobson Rd, Fort Wayne, IN 46805-1617 | 2005-10-20 |
| 1285633552 | Leor David Roubein | Internal Medicine | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1672 | 2005-07-19 |
| 1093718249 | Chung Seng Lee | Internal Medicine | 2622 Lake Ave, Fort Wayne, IN 46805-5410 | 2005-05-23 |
| 1043641475 | Zhaodong Li | Internal Medicine | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1733 | 2013-12-11 |
| 1407140015 | Chetan Mittal | Internal Medicine | 11050 Parkview Circle Dr, Fort Wayne, IN 46845 | 2011-06-01 |
| 1457669228 | Saurabh Gupta | Internal Medicine | 11104 Parkview Circle Dr, Suite 310, Fort Wayne, IN 46845-1672 | 2010-09-15 |
| 1902113830 | Mariajose Rojas De Leon | Internal Medicine | 11050 Parkview Circle Dr, Fort Wayne, IN 46845 | 2010-09-14 |
| 1598080236 | Reshi Chandra Kanuru | Internal Medicine | 11104 Parkview Circle Dr Ste 310, Fort Wayne, IN 46845-1672 | 2010-04-06 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
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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.