INDIANA CANCER SPECIALISTS, LLC (NPI# 1720528383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720528383 |
| Entity Type | Organization |
| Organization Name | INDIANA CANCER SPECIALISTS, LLC |
| Practice Address |
1907 W Sycamore St Kokomo IN 46901-5148 |
| Mailing Address |
8301 Harcourt Rd Suite 205 Indianapolis IN 46260-2081 |
| Practice Telephone | 7654565687 |
| Practice Fax Number | 7654565811 |
| Mailing Telephone | 3172283393 |
| Mailing Fax Number | 3178761305 |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |
| Authorized Official Name | SRIDHAR BOLLA (PRESIDENT) |
| Authorized Official Telephone | 3172283393 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336689702 | Indiana Cancer Specialists, LLC | Durable Medical Equipment & Medical Supplies | 8301 Harcourt Rd, Suite 205, Indianapolis, IN 46260-2081 | 2017-03-03 |
| 1366982910 | Indiana Cancer Specialists, LLC | Durable Medical Equipment & Medical Supplies | 1706 Lafayette Rd, Crawfordsville, IN 47933-1033 | 2017-03-01 |
| 1811437460 | Indiana Cancer Specialists, LLC | Durable Medical Equipment & Medical Supplies | 1111 Ronald Reagan Pkwy, Suite B1500, Avon, IN 46123-7085 | 2017-03-01 |
| 1902346562 | Indiana Cancer Specialists, LLC | Durable Medical Equipment & Medical Supplies | 100 Hospital Ln, Suite 320, Danville, IN 46122-1989 | 2017-03-01 |
| 1780124586 | Indiana Cancer Specialists, LLC | Nurse Practitioner | 8301 Harcourt Rd, Suite 205, Indianapolis, IN 46260-2081 | 2017-02-28 |
| Street Address |
1907 W SYCAMORE ST |
| City | KOKOMO |
| State | IN |
| Zip Code | 46901-5148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053313890 | Susan E Krier | Psychiatry & Neurology | 1907 W Sycamore St, Kokomo, IN 46901-5148 | 2005-08-11 |
| 1548896210 | Lana Wells | Nurse Practitioner | 1907 W Sycamore St, Kokomo, IN 46901-5148 | 2020-03-13 |
| 1750929592 | Sharon Isaacs | Registered Nurse | 1907 W Sycamore St, Kokomo, IN 46901-5148 | 2019-12-11 |
| 1528615796 | Emily R Denney | Physician Assistant | 1907 W Sycamore St, Kokomo, IN 46901-5148 | 2019-08-22 |
| 1568019230 | Benjamin York Constable | Physician Assistant | 1907 W Sycamore St, Kokomo, IN 46901-5148 | 2019-08-19 |
| 1306348040 | Toni Sue Vollmer | Nurse Practitioner | 1907 W Sycamore St, Kokomo, IN 46901-5148 | 2018-03-07 |
| 1851816656 | Lacey Diane Maul | Emergency Medicine | 1907 W Sycamore St, Kokomo, IN 46901-5148 | 2017-08-14 |
| 1043744451 | Amy Lynn Hemmelgarn | Physician Assistant | 1907 W Sycamore St, Kokomo, IN 46901-5148 | 2017-04-13 |
| 1316394992 | Alexander Facista | Family Medicine | 1907 W Sycamore St, Kokomo, IN 46901-5148 | 2016-05-24 |
| 1427412204 | Kristen Kile | Nurse Practitioner | 1907 W Sycamore St, Kokomo, IN 46901-5148 | 2016-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607597 | Momentum Kokomo, LLC | Substance Abuse Rehabilitation Facility | 1236 N. Wabash Ave, Kokomo, IN 46901 | 2020-10-23 |
| 1457826869 | Jodi Gayle Lake | Developmental Therapist | 2523 Lorentson Ct, Kokomo, IN 46901 | 2018-10-11 |
| 1871088369 | Hope Behavioral Servies, LLC | Behavioral Analyst | 924 Clark St, Kokomo, IN 46901 | 2018-06-27 |
| 1255782306 | Forefront Dermatology, S.c. | Dermatology | 2130 W Sycamore St Ste 200, Kokomo, IN 46901 | 2016-06-29 |
| 1164860706 | Renee Michelle Brown | Registered Nurse | 2776 Amberwood Place, Kokomo, IN 46901 | 2013-06-05 |
| 1063642916 | Michelle K Rush | Speech-Language Pathologist | 2532 Lauren Ln, Kokomo, IN 46901 | 2009-07-24 |
| 1396957189 | Lifetime Dental Care of In, PC | Dentist | 927 S Washington St, Kokomo, IN 46901 | 2007-05-04 |
| 1245458355 | Wagoner Medical Center, LLC | Internal Medicine | 2016 W Sycamore, Kokomo, IN 46901 | 2007-04-23 |
| 1053442723 | Jesusa Salhieh | Contractor | Genesis Rehab Bloom, Kokomo, IN 46901 | 2007-03-07 |
| 1740382928 | Donald A Fantuzzo Dds PC | Dentist | 2196 W Sycamore St, Kokomo, IN 46901 | 2006-09-01 |
| Find all providers in zip 46901 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548426786 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 2400 W Sycamore St, Kokomo, IN 46901-4035 | 2008-08-06 |
| 1316138464 | American Medical Supply Incorporated | Durable Medical Equipment & Medical Supplies | 4714 Glen Moor Way, Kokomo, IN 46902-9588 | 2007-08-05 |
| 1356497002 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2345 E Markland Ave, Kokomo, IN 46901-6245 | 2007-01-26 |
| 1205909827 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 605 N Dixon Rd, Kokomo, IN 46901-1734 | 2006-11-15 |
| 1417032558 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 2130 W Sycamore St, Suite 190, Kokomo, IN 46901-4122 | 2006-10-26 |
| 1508963091 | Hook Superx LLC | Durable Medical Equipment & Medical Supplies | 610 W Markland Ave, Kokomo, IN 46901-6110 | 2006-09-19 |
| 1962505644 | Hook Superx LLC | Durable Medical Equipment & Medical Supplies | 401 E Morgan St, Kokomo, IN 46901-2357 | 2006-09-07 |
| 1245245380 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3608 S Lafountain St, Kokomo, IN 46902-3809 | 2006-07-29 |
| 1417979139 | Hook-superx LLC | Durable Medical Equipment & Medical Supplies | 1037 S Reed Rd, Kokomo, IN 46902-1929 | 2006-07-24 |
| 1851372049 | Moore Drug Store, Inc. | Durable Medical Equipment & Medical Supplies | 909 S Courtland Ave, Kokomo, IN 46901-5359 | 2005-11-07 |
| Find all providers in KOKOMO | ||||
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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.