OPTIMAL HEALTH NETWORK OF INDIANA LLC (NPI# 1710485594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710485594 |
| Entity Type | Organization |
| Organization Name | OPTIMAL HEALTH NETWORK OF INDIANA LLC |
| Practice Address |
120 E Market St Ste 1271 Indianapolis IN 46204-3250 |
| Mailing Address |
102 Woodmont Blvd Ste 350 Nashville TN 37205-2216 |
| Practice Telephone | 6153860064 |
| Practice Fax Number | 6153860067 |
| Mailing Telephone | 6153860064 |
| Mailing Fax Number | 6153860067 |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2020-02-13 |
| Authorized Official Name | EDWARD LELAND HUTTON EADIE (DIRECTOR) |
| Authorized Official Telephone | 6157332064 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
IN | Allopathic & Osteopathic Physicians | |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
IN | Allopathic & Osteopathic Physicians |
| Street Address |
120 E MARKET ST STE 1271 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46204-3250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972065415 | Cind Care of In II, LLC | Internal Medicine | 120 E Market St Ste 1271, Indianapolis, IN 46204-3250 | 2019-04-03 |
| 1922560465 | Cind Care of In, LLC | Internal Medicine | 120 E Market St Ste 1271, Indianapolis, IN 46204-3250 | 2019-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982245593 | Melvin Jay Prince | Internal Medicine | Gennesaret Free Clinic 615 N Alabama St, Suite 136, Indianapolis, IN 46204 | 2019-10-04 |
| 1487203139 | Elizabeth Ann Wilson | Behavior Technician | 120 N East St Ste 1233, Indianapolis, IN 46204 | 2019-09-05 |
| 1225691207 | Kawthar Mohamed | Student in an Organized Health Care Education/Training Program | 120 W Michigan St # Cl630, Indianapolis, IN 46204 | 2019-04-16 |
| 1457853962 | Tracie Lynn King | Physical Therapy Assistant | 500 N Capitol Ave Unit A, Indianapolis, IN 46204 | 2018-03-01 |
| 1013436831 | Kayla Michelle Jackson | Social Worker | 1099 North Meridian Street, Suite 900, Indianapolis, IN 46204 | 2017-09-13 |
| 1912434010 | Latrice N Baxter | Counselor | 201 N. Illinois Street, 16th Floor, South Tower, Indianpolis, IN 46204 | 2017-05-19 |
| 1750820643 | Jcpl, LLC | Optometrist | 751 Massachusetts Ave, Indianapolis, IN 46204 | 2017-02-13 |
| 1922546969 | Makenzie Brinker | Specialist/Technologist | 800 N. Capital Ave, 420, Indianapolis, IN 46204 | 2017-02-10 |
| 1598118572 | Jennifer Clark | Internal Medicine | 1120 W. Michigan Street Gatch Hall Cl 630, Indianapolis, IN 46204 | 2016-07-14 |
| 1194176263 | Bradley Cox | Dentist | 451 E Market St Apt 448, Indianapolis, IN 46204 | 2016-06-29 |
| Find all providers in zip 46204 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1124381751 | Robert W Godley II | Internal Medicine | Community Physicians of Indiana, Inc., 1402 E. County Line Rad, Indianapolis, IN 46227-0963 | 2012-06-19 |
| 1154550143 | Vitality Health Group | Internal Medicine | 1702 W Michigan St, Indianapolis, IN 46222-3983 | 2009-07-10 |
| 1689860819 | Mohammad M Marashdeh | Internal Medicine | 1400 N Ritter Ave Ste 520, Indianapolis, IN 46219-3052 | 2007-09-20 |
| 1346448305 | Mark Daniel Fisch | Internal Medicine | 1801 N Senate Boulevard, Suite 310, Indianapolis, IN 46202-1196 | 2007-07-10 |
| 1669550588 | Heart Partners of Indiana LLC | Internal Medicine | 8075 N Shadeland, #350, Indianapolis, IN 46250 | 2006-11-01 |
| 1821186933 | Bertram Anthony Graves | Internal Medicine | 3737 N. Meridian St., Suite 104, Indianapolis, IN 46208-4357 | 2006-10-11 |
| 1902860752 | Douglas P Zipes | Internal Medicine | 1801 N Capitol Ave, Indianapolis, IN 46202-1217 | 2006-04-17 |
| 1275532525 | Richard Hahn | Internal Medicine | 1207 Selkirk Ln, Indianapolis, IN 46260-1227 | 2005-07-19 |
| 1487651329 | Louis F. Janeira | Internal Medicine | 5330 E Stop 11 Rd, Indianapolis, IN 46237-6345 | 2005-07-07 |
| 1922560465 | Cind Care of In, LLC | Internal Medicine | 120 E Market St Ste 1271, Indianapolis, IN 46204-3250 | 2019-04-03 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46204 |
Please comment or provide details below to improve the information on OPTIMAL HEALTH NETWORK OF INDIANA LLC.
| 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.