GLENN A MANDEVILLE (NPI# 1942318795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942318795 |
| Entity Type | Individual |
| Full Name | GLENN A MANDEVILLE |
| Credential | M.D. |
| Practice Address |
1429 N 6th St Terre Haute IN 47807-1037 |
| Mailing Address |
221 S 6th St Terre Haute IN 47807-4214 |
| Practice Telephone | 8122423110 |
| Practice Fax Number | 8122423795 |
| Mailing Telephone | 8122423110 |
| Mailing Fax Number | 8122423795 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2013-03-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 01041222A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | RAILROAD MEDICARE | P00834915 | 01 |
| RAILROAD MCARE PALAMETTO | 020024441 | 01 | |
| ANTHEM | 000000089623 | 01 | |
| IN | 100337060 | 05 |
| Street Address |
1429 N 6TH ST |
| City | TERRE HAUTE |
| State | IN |
| Zip Code | 47807-1037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396749966 | Karen Ann Tisinai | Surgery | 1429 N 6th St, Terre Haute, IN 47807-1037 | 2005-06-10 |
| 1497362438 | Loganne D Wertz | Physician Assistant | 1429 N 6th St, Terre Haute, IN 47807-1019 | 2020-09-24 |
| 1346861788 | Marcy Aldrich | Nurse Practitioner | 1429 N 6th St, Terre Haute, IN 47807-1019 | 2020-04-27 |
| 1538798210 | Bernice Imogene Morris | Nurse Practitioner | 1429 N 6th St, Terre Haute, IN 47807-1019 | 2020-04-05 |
| 1760043566 | Alexandra Strunk | Physician Assistant | 1429 N 6th St, Terre Haute, IN 47807-1019 | 2019-06-24 |
| 1366917965 | Rebecca Proctor | Nurse Practitioner | 1429 N 6th St, Terre Haute, IN 47807-1019 | 2018-10-10 |
| 1326535816 | Kindra Lee Shepard | Nurse Practitioner | 1429 N 6th St, Terre Haute, IN 47807-1019 | 2018-04-19 |
| 1992150965 | Jennifer Gruber | Nurse Practitioner | 1429 N 6th St, Terre Haute, IN 47807-1019 | 2016-04-27 |
| 1821467689 | Sarah Kachman | Nurse Practitioner | 1429 N 6th St, Terre Haute, IN 47807-1019 | 2015-09-22 |
| 1538572862 | Mohammed Zaher | Urology | 1429 N 6th St, Terre Haute, IN 47807-1019 | 2014-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972150175 | Acceleraed Rehabilitation Centers Ltd | Physical Therapist | 516 Wabash Ave, Terre Haute, IN 47807 | 2019-08-22 |
| 1548753403 | Terre Haute Aal Lp | Assisted Living Facility | 650 Lafayette Avenue, Terre Haute, IN 47807 | 2018-06-14 |
| 1790286300 | Hamilton Center, Inc. | Clinic/Center | 88 Court Wabash Court, Terre Haute, IN 47807 | 2018-02-28 |
| 1073022703 | Charles Martinez | Case Manager/Care Coordinator | 1619 5th Ave, Terre Haute, IN 47807 | 2017-09-26 |
| 1326578931 | Ian Nicholas Bostock | Specialist/Technologist | 1113 North 8th Street, Terre Haute, IN 47807 | 2017-06-15 |
| 1619309804 | Kimberly R Rollings | Audiologist | 1429 North Sixth Street, Terre Haute, IN 47807 | 2013-07-30 |
| 1376827550 | Lazaro Vu | Pharmacist | 1300 Wabash Avenue, Terre Haute, IN 47807 | 2011-10-05 |
| 1609016211 | Midwest Neurosurgery, P.C. | Specialist | 1530 N. 7th Street, Suite 106, Terre Haute, IN 47807 | 2009-02-23 |
| 1114007838 | Micheal J Deady Dds Inc | Oral & Maxillofacial Surgery | 1630 Poplar St, Terre Haute, IN 47807 | 2006-10-17 |
| 1316958549 | Wabash Valley Urological Assoc Inc | Specialist | 1235 Ohio Street, Terre Haute, IN 47807 | 2006-08-11 |
| Find all providers in zip 47807 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215132907 | Janie L Orrington-myers | Surgery | 3903 S 7th St Ste 2d, Terre Haute, IN 47802-5710 | 2007-06-20 |
| 1164523783 | Francis V. Tapia | Surgery | 3311 S 7th St, Terre Haute, IN 47802-4014 | 2006-09-26 |
| 1144275819 | Noaman Noshi Botros | Surgery | 1429 N 8th St, Terre Haute, IN 47807-1136 | 2006-05-23 |
| 1619966462 | David Andrew Southwick | Surgery | 5969 S Ernest St, Terre Haute, IN 47802-8111 | 2005-10-14 |
| 1063404259 | Custodio L. Lim | Surgery | 2235 Wabash Ave, Terre Haute, IN 47807-3330 | 2005-08-16 |
| 1396749966 | Karen Ann Tisinai | Surgery | 1429 N 6th St, Terre Haute, IN 47807-1037 | 2005-06-10 |
| 1548264823 | Mark O Lynch | Surgery | 1818 N 6th St, Terre Haute, IN 47804-4021 | 2005-06-02 |
| 1992124994 | Nicholas C Lynch | Surgery | 1818 N 6th St, Terre Haute, IN 47804-4021 | 2014-04-08 |
| 1487910626 | Brandon Frank Lynch | Surgery | 1818 N 6th St, Terre Haute, IN 47804-4021 | 2012-04-02 |
| 1104137603 | Rebecca Elizabeth Lynch | Surgery | 1818 N 6th St, Terre Haute, IN 47804-4021 | 2010-06-29 |
| Find all providers in TERRE HAUTE | ||||
| City | TERRE HAUTE |
| Zip Code | 47807 |
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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.