JEFFREY ANDERSON (NPI# 1902822836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902822836 |
| Entity Type | Individual |
| Full Name | JEFFREY ANDERSON |
| Credential | M.D., FAEP |
| Practice Address |
1007 Lincolnway La Porte IN 46350-3201 |
| Mailing Address |
75 Remit Dr No 3309 Chicago IL 60675-3309 |
| Practice Telephone | 2193261234 |
| Mailing Telephone | 8669165259 |
| Mailing Fax Number | 2319224030 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2008-02-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 01037772A | IN | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326524596 | Jeffrey Anderson | Dentist | 2304 E Bidwell St # 100, Folsom, CA 95630-3455 | 2018-07-11 |
| 1295238830 | Jeffrey Todd Anderson | Occupational Therapist | 100 Woodbrook Dr, Charlottesville, VA 22901-1147 | 2018-03-09 |
| 1902263700 | Jeffrey Anderson | Durable Medical Equipment & Medical Supplies | 420 S 100 E, Farmington, UT 84025-2276 | 2016-01-25 |
| 1891151015 | Jeffrey Anderson | Counselor | 555 S Palm Canyon Dr Ste A202, Palm Springs, CA 92264-7210 | 2016-01-04 |
| 1801294558 | Jeffrey Paul Anderson | Registered Nurse | 1992 S Gregg Rd, Akron, OH 44319-1306 | 2014-12-11 |
| 1013336890 | Jeffrey Anderson | Student in an Organized Health Care Education/Training Program | 1959 Ne Pacific Street, Box 356410, University of Washington, Department of Surgery, Seattle, WA 98195 | 2014-04-09 |
| 1700223708 | Jeffrey Davis Anderson | Dentist | 5754 Antioch Rd, Merriam, KS 66202-2015 | 2013-05-30 |
| 1659608578 | Jeffrey G. Anderson | Spec/Tech, Pathology | Psc 461, Medical Unit, Fpo, AP 96521-0050 | 2009-11-13 |
| 1326371212 | Jeffrey Alan Anderson | Physician Assistant | 410 Sheridan Ave - 529th Rsc, Attn: Regimental Aid Station, Fort Myer, VA 22211 | 2009-09-10 |
| 1306094420 | Jeffrey Scott Anderson | Counselor | 226 Linda Ave., Hawthorne, NY 10532 | 2008-09-03 |
| Street Address |
1007 LINCOLNWAY |
| City | LA PORTE |
| State | IN |
| Zip Code | 46350-3201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699304907 | Katherine Elizabeth Davis | Occupational Therapist | 1007 Lincolnway, La Porte, IN 46350-3290 | 2020-04-07 |
| 1245864057 | Mitchell Steven Molenda | Nurse Practitioner | 1007 Lincolnway, La Porte, IN 46350-3290 | 2020-03-02 |
| 1295381580 | Samantha Burrows | Specialist/Technologist | 1007 Lincolnway, La Porte, IN 46350-3201 | 2019-08-13 |
| 1447805072 | Jill Renee Oscarson | Speech-Language Pathologist | 1007 Lincolnway, La Porte, IN 46350-3201 | 2019-08-09 |
| 1922663863 | Ashley Lysle Miller | Physical Medicine & Rehabilitation | 1007 Lincolnway, La Porte, IN 46350-3290 | 2019-05-07 |
| 1780249946 | Kyleigh Fife | Physical Therapist | 1007 Lincolnway, La Porte, IN 46350-3201 | 2019-05-03 |
| 1629542204 | Krista Marie Kerby | Occupational Therapist | 1007 Lincolnway, La Porte, IN 46350-3201 | 2019-01-16 |
| 1538659560 | Stephanie Maris Kadish | Nurse Practitioner | 1007 Lincolnway, La Porte, IN 46350-3290 | 2018-05-15 |
| 1346760873 | Cary Lynn Malstaff | Nurse Practitioner | 1007 Lincolnway, La Porte, IN 46350-3201 | 2017-06-26 |
| 1134652340 | Pathology Associates of Northwest Indiana Inc | Pathology | 1007 Lincolnway, La Porte, IN 46350-3201 | 2017-04-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871139246 | Carolyn Ann Perra | Pharmacist | 55 Pine Lake S.c., Laporte, IN 46350 | 2019-11-20 |
| 1306496492 | Trinity Healthcare Inc. | Occupational Therapist | 2002 Andrew Avenue, Laporte, IN 46350 | 2019-09-19 |
| 1184136665 | Diane Margaret Rich | Physical Therapist | 1643 S Willow Bend Dr, La Porte, IN 46350 | 2017-10-24 |
| 1114460102 | Judith Marie Fitzhugh | Dietitian, Registered | 1775 S. Basswood Trail, Laporte, IN 46350 | 2016-11-23 |
| 1568916971 | Total Renal Care, Inc. | Clinic/Center | 1406 E Lincolnway, Ste A, La Porte, IN 46350 | 2016-08-15 |
| 1083079008 | Irene Torres | Nurse Practitioner | 1407 Lincolnway, La Porte, IN 46350 | 2015-12-17 |
| 1124422910 | Becky Alwood-wallace | Occupational Therapist | 1203 Washington Street, Iu Health La Porte Hospital Wellness & Rehabilitation, La Porte, IN 46350 | 2014-10-22 |
| 1881001527 | Johnson Memorial Hospital | Skilled Nursing Facility | 3530 Monroe Street, La Porte, IN 46350 | 2014-07-15 |
| 1306268941 | Tiffany Anne Satterfield | Physical Therapy Assistant | 194 S 400 E, Laporte, IN 46350 | 2014-01-16 |
| 1801122239 | Mary Barbara Backer | Internal Medicine | 301 Willow Bend Dr, La Porte, IN 46350 | 2009-10-20 |
| Find all providers in zip 46350 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487049466 | Najeem Temmy Ojulari | Emergency Medicine | 1007 Lincolnway, La Porte, IN 46350 | 2015-04-06 |
| 1235360165 | Avida Nubia Bussell | Emergency Medicine | 1007 Lincolnway, La Porte, IN 46350-3201 | 2009-07-27 |
| 1013133396 | Joseph Lee Newberg | Emergency Medicine | 1007 Lincolnway, La Porte, IN 46350 | 2007-04-17 |
| 1164555884 | April Lee Bisaga | Emergency Medicine | 1007 Lincolnway, La Porte, IN 46350-3201 | 2007-03-13 |
| 1669582698 | Almuhannad Alfrhan | Emergency Medicine | 1007 Lincolnway, La Porte, IN 46350-3201 | 2006-08-31 |
| 1750494381 | Michael Stuart Hawthorne | Emergency Medicine | 1007 Lincolnway, La Porte, IN 46350 | 2006-08-17 |
| 1750306163 | Regina M Iwinski | Emergency Medicine | 1007 Lincolnway, La Porte, IN 46352-0250 | 2006-07-13 |
| 1346265691 | Natalie M Painter | Emergency Medicine | 1007 Lincolnway, La Porte, IN 46352-0250 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396358255 | Vyvian Charlene Lawrence | Emergency Medicine | 5939 W Lincoln Hwy, Crown Point, IN 46307-9604 | 2020-08-28 |
| 1508358128 | Antonino Bucca | Emergency Medicine | 720 Eskenazi Ave Bldg 3, Indianapolis, IN 46202-5187 | 2018-05-30 |
| 1124518931 | Evan Mitchell Landry Tomkiewicz | Emergency Medicine | 720 Eskenazi Ave Fl Ft3, Indianapolis, IN 46202-5187 | 2018-05-16 |
| 1760907299 | Timothy John Howard | Emergency Medicine | 610 1/2 N Main Street, Apartment 1, Mishawaka, IN 46545 | 2017-08-05 |
| 1760913891 | Nathan Francis Marcinkowski | Emergency Medicine | 216 N 4th St Ste 205, Lafayette, IN 47901-1323 | 2017-03-21 |
| 1154777613 | Michael J Bojrab | Emergency Medicine | 6720 Kirkdale Dr, Fort Wayne, IN 46815-5524 | 2016-05-13 |
| 1114307063 | Grant Fabian Chernoby | Emergency Medicine | 701 N Senate Ave # B401, Indianapolis, IN 46202-3111 | 2015-06-05 |
| 1457730830 | Patrick Lee Studtman | Emergency Medicine | 615 N. Michigan Street, Emergency Department, South Bend, IN 46601-1033 | 2015-05-19 |
| 1861888430 | Enola Okonkwo | Emergency Medicine | 9785 Valley Springs Blvd, Fishers, IN 46037-8764 | 2015-04-10 |
| 1518355882 | Marlin R. Gray | Emergency Medicine | 925 N. County Rd., 1100e, Otwell, IN 47564 | 2015-01-08 |
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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.