MRS. LAUREN D FAHEY (NPI# 1750614400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750614400 |
| Entity Type | Individual |
| Full Name | MRS. LAUREN D FAHEY |
| Other Name | MISS LAUREN D KEYES |
| Credential | PA-C |
| Practice Address |
1115 Ronald Reagan Pkwy Suite 348 Avon IN 46123-6910 |
| Mailing Address |
3755 E 82nd St Ste 75 Indianapolis IN 46240-0028 |
| Practice Telephone | 3179263739 |
| Practice Fax Number | 3179217478 |
| Mailing Telephone | 3179263739 |
| Mailing Fax Number | 3179217478 |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2011-03-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 99039119A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM | PENDING | 01 |
| Street Address |
1115 RONALD REAGAN PKWY SUITE 348 |
| City | AVON |
| State | IN |
| Zip Code | 46123-6910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679573620 | James C Sloan | Urology | 1115 Ronald Reagan Pkwy, Ste 364, Avon, IN 46123-6910 | 2005-07-29 |
| 1487111274 | Ann Shackelford Reeves | Nurse Practitioner | 1115 Ronald Reagan Pkwy, Avon, IN 46123-6910 | 2019-02-27 |
| 1215412432 | Heather Renee Seaborne | Registered Nurse | 1115 Ronald Reagan Pkwy, Avon, IN 46123-6910 | 2018-10-03 |
| 1770959744 | Chelsea Durnil | Pharmacist | 1115 Ronald Reagan Pkwy, Ste 318, Avon, IN 46123-6910 | 2015-08-13 |
| 1578961314 | Urology of Indiana L.l. C. | Durable Medical Equipment & Medical Supplies | 1115 Ronald Reagan Pkwy, Suite 247, Avon, IN 46123-6910 | 2014-12-10 |
| 1639445315 | Thomas A Brady Sports Medicine Ctr | Durable Medical Equipment & Medical Supplies | 1115 Ronald Reagan Pkwy, Avon, IN 46123-6910 | 2012-03-28 |
| 1912290925 | Kyle Andrew Frick | Internal Medicine | 1115 Ronald Reagan Pkwy, Avon, IN 46123-6910 | 2011-05-24 |
| 1831405422 | Amanda N Crishon | Audiologist | 1115 Ronald Reagan Pkwy, Ste 225, Avon, IN 46123-6910 | 2010-08-20 |
| 1831410703 | Robert Neal Ingram | Registered Nurse | 1115 Ronald Reagan Pkwy, Pkwy 171, Avon, IN 46123-6910 | 2010-06-15 |
| 1316276363 | Indianapolis Neurosurgical Group | Nurse Practitioner | 1115 Ronald Reagan Pkwy, Suite 148, Avon, IN 46123-6910 | 2009-12-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669018669 | Dienye Williams | Pharmacist | 108 North Sr 267, Avon, IN 46123 | 2019-11-25 |
| 1992353817 | Debra Blackwell | Technician | 8198 Montage Ave, Apt 104, Avon, IN 46123 | 2019-09-04 |
| 1932675766 | Blake Ponist | Occupational Therapist | 10940 E U S Highway 36, Rockville Rd, Avon, IN 46123 | 2018-10-19 |
| 1396238150 | Sarah Sweany | Dietitian, Registered | Iu Health West Cancer Center, 1111 North Ronald Reagen Pkwy Suite B1600, Avon, IN 46123 | 2018-06-07 |
| 1124516257 | Sheree Itza | Counselor | 6655 E Us Highway 36 Ste 100, Avon, IN 46123 | 2018-04-24 |
| 1255860607 | Jonathan Lambert | Dentist | 110 N Avon Ave B, Avon, IN 46123 | 2017-06-08 |
| 1023546629 | 10439 E Us Highway 36 Dental, LLC | Dentist | 10439 E Us Highway 36, Avon, IN 46123 | 2017-05-25 |
| 1902330756 | Melissa Wheatley | Occupational Therapy Assistant | 6294 Forest View Court, Avon, IN 46123 | 2017-04-19 |
| 1932555844 | Gal Marcan | Family Medicine | 1351 Ronald Reagan Pkwy Ste B, Avon, IN 46123 | 2016-05-10 |
| 1962871301 | Annette Joelene Oechsle | Health Educator | 1820 South County Road 525 East, Avon, IN 46123 | 2015-09-16 |
| Find all providers in zip 46123 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831702570 | Nathan Dean Hailey | Physician Assistant | 1115 Ronald Reagan Pkwy Ste 247, Avon, IN 46123-6911 | 2020-08-24 |
| 1841848298 | Kayla Nichole Kawiecki | Physician Assistant | 2351 Chelsea St, Avon, OH 44011-5227 | 2019-08-29 |
| 1831591791 | Michael Czajka | Physician Assistant | 33100 Cleveland Clinic Blvd # 2-2, Avon, OH 44011-1390 | 2014-09-23 |
| 1043558596 | Kelly L Foutch | Physician Assistant | 8607 E Us Highway 36 Ste 300, Avon, IN 46123-7960 | 2013-01-17 |
| 1215291943 | Mari E. Friedman | Physician Assistant | 1115 Ronald Reagan Pkwy Ste 348, Avon, IN 46123 | 2012-06-27 |
| 1346523636 | Amanda Duncan | Physician Assistant | 33100 Cleveland Clinic Blvd # 2-1, Avon, OH 44011-1390 | 2011-09-22 |
| 1134376304 | Katherine B Bares | Physician Assistant | 8 Canal Ct, Avon, CT 06001-3726 | 2008-08-19 |
| 1205059185 | Peter J. Dolan | Physician Assistant | 2077 Lakeville Rd, Suite 3, Avon, NY 14414 | 2007-04-10 |
| 1689640948 | Scott D. Petersen | Physician Assistant | 33300 Cleveland Clinic Blvd, Mail Code Avh4-143, Avon, OH 44011 | 2006-02-27 |
| 1467459206 | Don Armenoff | Physician Assistant | 8244 E Us Highway 36 Ste 1100, Avon, IN 46123-9627 | 2005-07-07 |
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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.