GREAT LAKES ANESTHESIA, P.C. (NPI# 1720039977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720039977 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES ANESTHESIA, P.C. |
| Practice Address |
1004 Parkway Ave Suite B Elkhart IN 46516 |
| Practice Telephone | 5745229922 |
| Practice Fax Number | 5745229926 |
| Mailing Telephone | 5745229922 |
| Mailing Fax Number | 5745229926 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2015-08-25 |
| Authorized Official Name | MR. JAMES J CARR (PRESIDENT, CEO) |
| Authorized Official Telephone | 5745229922 |
| Authorized Official Credential | CRNA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 367500000X | Nurse Anesthetist, Certified Registered | IN | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200250870 | 05 |
| Street Address |
1004 PARKWAY AVE SUITE B |
| City | ELKHART |
| State | IN |
| Zip Code | 46516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043288475 | Marquessa D Fisher | Nurse Anesthetist, Certified Registered | 1004 Parkway Ave, Suite B, Elkhart, IN 46516-9348 | 2006-03-10 |
| 1730626979 | Malee Blue | Registered Nurse | 1004 Parkway Ave, Elkhart, IN 46516-9348 | 2017-01-26 |
| 1083074462 | Angela Gingerich | Social Worker | 1004 Parkway Ave, Suite D, Elkhart, IN 46516-9348 | 2016-02-29 |
| 1033584495 | Barbara Ann Doherty | Nurse Anesthetist, Certified Registered | 1004 Parkway Ave, Suite B, Elkhart, IN 46516-9348 | 2015-12-09 |
| 1558705368 | Joanna Beth Woolace | Social Worker | 1004 Parkway Ave, Suite D, Elkhart, IN 46516-9348 | 2013-04-23 |
| 1295028694 | Crossroads Healing Arts, LLC | Preventive Medicine | 1004 Parkway Ave, Suite C, Elkhart, IN 46516-9326 | 2011-05-18 |
| 1801198395 | Seth Michael Claxton | Nurse Anesthetist, Certified Registered | 1004 Parkway Ave, Suite B, Elkhart, IN 46516-9348 | 2010-12-03 |
| 1710215686 | Erin E Hillers | Nurse Practitioner | 1004 Parkway Ave, Elkhart, IN 46516-9348 | 2009-12-03 |
| 1326071952 | Reed Stockman | Nurse Anesthetist, Certified Registered | 1004 Parkway Ave, Suite B, Elkhart, IN 46516-9348 | 2006-07-08 |
| 1508802919 | Benny Buslon | Anesthesiology | 1004 Parkway Ave, Suite B, Elkhart, IN 46516-9348 | 2006-06-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558974675 | Courtney Rae Lawson | Nurse Practitioner | 1178 Fremont Ct., Elkhart, IN 46516 | 2020-08-28 |
| 1932690955 | Lisa Cooper | Counselor | 529 S 2nd St, Elkhart, IN 46516 | 2018-05-24 |
| 1780183558 | Evolve Chiropractic, LLC | Chiropractor | 5301 Beck Dr. Suite 3, Elkhart, IN 46516 | 2018-02-07 |
| 1790215168 | Cutting Edge Integrative Pain Centers LLC | Internal Medicine | 242 Waterfall Dr Ste B, Elkhart, IN 46516 | 2017-06-18 |
| 1831448745 | Planned Parenthood of Indiana Elkhart | Clinic/Center | 505 S. Third St., Suite 160, Elkhart, IN 46516 | 2012-09-06 |
| 1588920128 | Physical Therapy Professionals PC | Clinic/Center | 932 Parkway Ave, Ste. B, Elkhart, IN 46516 | 2012-04-09 |
| 1821369091 | Marek Serwatka | Physical Therapist | 932 Parkway Ave Ste B, Elkhart, IN 46516 | 2012-01-19 |
| 1538459904 | Rose M. Mwania | Nurse Anesthetist, Certified Registered | 1004 Parkway Ave Ste A, Elkhart, IN 46516 | 2011-04-19 |
| 1487894838 | Jack Alan Turnock | Dentist | 330 West Lexington Ave, Suite 201, Elkhart, IN 46516 | 2009-02-25 |
| 1225207285 | Wal-mart Stores East, Lp | Eyewear Supplier (Equipment, not the service) | 30830 Old Us 33, Elkhart, IN 46516 | 2008-02-25 |
| Find all providers in zip 46516 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003469495 | Clinical Colleagues of Indiana PC | Anesthesiology | 500 Arcade Ave Ste 100, Elkhart, IN 46514-2478 | 2019-07-24 |
| 1174651228 | Tia Reardon | Anesthesiology | 500 N Nappanee St Ste 11b, Elkhart, IN 46514-1500 | 2007-03-01 |
| 1104882380 | Yaksha Thakrar | Anesthesiology | 3080 Windsor Ct Suite B, Elkhart, IN 46514 | 2006-04-25 |
| 1982678165 | Elizabeth Konefal | Anesthesiology | 500 N Nappanee, Suite 11b, Elkhart, IN 46514 | 2006-02-15 |
| 1952371155 | Beth Ann Snider | Anesthesiology | 500 N Nappance, Ste 11b, Elkhart, IN 46514 | 2006-01-23 |
| 1295719797 | Derek T Cheuk | Anesthesiology | 3080 Windsor Ct, Suite 8, Elkhart, IN 46514-5555 | 2005-11-30 |
| 1528065190 | Robert Bart Powers | Anesthesiology | 500 N Nappanee St, Suite 11b, Elkhart, IN 46514-1503 | 2005-06-28 |
| 1518301118 | Austin Wade Pulliam | Anesthesiology | 600 East Blvd, Elkhart, IN 46514-2483 | 2013-04-25 |
| 1821331703 | David Theophilus Gursky | Anesthesiology | 600 East Blvd, Elkhart, IN 46514-2483 | 2013-03-29 |
| 1366645178 | Jonathan D Schrock | Anesthesiology | 2310 California Road, Elkhart, IN 46514-1228 | 2007-06-08 |
| Find all providers in ELKHART | ||||
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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.