INDIANA UNIVERSITY HEALTH PROTON THERAPY CENTER, LLC (NPI# 1780775163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780775163 |
| Entity Type | Organization |
| Organization Name | INDIANA UNIVERSITY HEALTH PROTON THERAPY CENTER, LLC |
| Other Organization Name | MIDWEST PROTON RADIOTHERAPY INSTITUTE, LLC |
| Practice Address |
2425 Milo B. Sampson Lane Bloomington IN 47408-1398 |
| Practice Telephone | 8123495074 |
| Practice Fax Number | 8123495046 |
| Mailing Telephone | 8123495074 |
| Mailing Fax Number | 8123495046 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2012-11-28 |
| Authorized Official Name | MR. JOHN KERSTIENS (COO/CFO) |
| Authorized Official Telephone | 8123495028 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QX0203X |
Clinic/Center Specialization: Oncology, Radiation |
NA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200442910A | 05 |
| Other Name | Type Code |
|---|---|
| Midwest Proton Radiotherapy Institute, LLC | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | INDIANA UNIVERSITY HEALTH PROTON THERAPY CENTER, LLC | 2425 North Milo B Sampson Lane, Bloomington, IN 47408 |
| Street Address |
2425 MILO B. SAMPSON LANE |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47408-1398 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932159860 | Markus M. Fitzek | Radiology | 2425 Milo B. Sampson Lane, Bloomington, IN 47408-1398 | 2006-05-11 |
| 1841335874 | Teresa Ann Oldham | Radiology | 2425 Milo B. Sampson Lane, Bloomington, IN 47408-1398 | 2007-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669079398 | Ta-kisha Jones | Health Educator | 309 N. Woodlawn Ave, Bloomington, IN 47408 | 2020-10-06 |
| 1265915904 | Meghan Elizabeth Kinkead | Specialist/Technologist | Simon Skjodt Assembly Hall, 1001 East 17th Street, Bloomington, IN 47408 | 2018-09-10 |
| 1316499395 | Marabai Rose Counseling, LLC | Social Worker | 4568 East State Rd 45, Bloomington, IN 47408 | 2016-10-26 |
| 1295133908 | Eden Embree | Specialist/Technologist | 1001 E. 17th Street, Assembly Hall, Bloomington, IN 47408 | 2014-12-11 |
| 1588995229 | Create-a-smile PC | Dentist | 219 E. 17th St., Bloomington, IN 47408 | 2010-01-20 |
| 1609053289 | Laurette Frazier | Counselor | 2815 E. 10th Street, Stone Belt, Bloomington, IN 47408 | 2008-01-26 |
| 1770709917 | Robin A. Roberts | Dentist | 104 E. 19th Street, Bloomington, IN 47408 | 2007-04-17 |
| 1376614008 | David Rudolf Fletcher | General Practice | 126 S. Hampton Ct, Bloomington, IN 47408 | 2006-11-13 |
| 1114013752 | Christole, Inc | Intermediate Care Facility, Mentally Retarded | 2727 N Dunn, Bloomington, IN 47408 | 2006-10-04 |
| 1003850322 | Priti V Jindal | Internal Medicine | 2455 N Tamarack Trl, Bloomington, IN 47408 | 2006-06-16 |
| Find all providers in zip 47408 | ||||
| Taxonomy Code | 261QX0203X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oncology, Radiation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609984301 | Progressive Cancer Care LLC | Clinic/Center | 831 N Theatre Rd, Marion, IN 46952-1701 | 2006-08-25 |
| 1548508815 | Franklin Radiation LLC | Clinic/Center | 310 Birch St, Crown Point, IN 46307-2607 | 2013-01-22 |
| 1295043925 | Radiotherapy Clinics of Kentuckiana, LLC | Clinic/Center | 1322 Spring St, Jeffersonville, IN 47130-3706 | 2010-09-15 |
| 1508935552 | Greater Lafayette Health Services | Clinic/Center | 1425 Unity Pl, Lafayette, IN 47905-5756 | 2006-11-06 |
| City | BLOOMINGTON |
| Zip Code | 47408 |
Please comment or provide details below to improve the information on INDIANA UNIVERSITY HEALTH PROTON THERAPY CENTER, 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.