TANYANAN TANAWUTTIWAT (NPI# 1992980767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992980767 |
| Entity Type | Individual |
| Full Name | TANYANAN TANAWUTTIWAT |
| Credential | M.D. |
| Practice Address |
1701 N Senate Blvd Heart Station A1089 Indianapolis IN 46202-1239 |
| Mailing Address |
250 N Shadeland Ave Ste 200 Indianapolis IN 46219-4959 |
| Practice Telephone | 3179628447 |
| Mailing Telephone | 3179633137 |
| Enumeration Date | 2007-12-29 |
| Last Update Date | 2020-01-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
01083239A | IN | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
23750 | MS | Allopathic & Osteopathic Physicians |
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
312475 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 07278029 | 05 | |
| IN | LICENSE | 01083239A | 01 |
| MS | RAILROAD MEDICARE | P01590534 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2500 N State St, Jackson, MS 392164500 | 6019845678 | 6019845638 |
| Street Address |
1701 N SENATE BLVD HEART STATION A1089 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46202-1239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073501235 | Lara Jane Pesavento | Anesthesiology | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2005-10-12 |
| 1508475526 | Wade Everett Oliver | Nurse Practitioner | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-07-27 |
| 1538778600 | Marleana Leann Groh | Nurse Practitioner | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-07-24 |
| 1982225447 | Saily Jacqueline Guerra | Dietitian, Registered | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-05-06 |
| 1013538826 | Paige Randolph | Nurse Practitioner | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-05-04 |
| 1780213926 | John Peacock | Student in an Organized Health Care Education/Training Program | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-04-08 |
| 1295354462 | Kylie J Miller | Student in an Organized Health Care Education/Training Program | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-04-08 |
| 1962031492 | Kristina Lynn Mathey | Counselor | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-04-06 |
| 1023647674 | Lindsay Nicole Troyer | Student in an Organized Health Care Education/Training Program | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-04-06 |
| 1548894686 | Courtney Leanne Kroes | Social Worker | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-02-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386886 | Sara Brooke Horn | Registered Nurse | 1801 N Senate Ave Ste 3300, Indianapolis, IN 46202 | 2020-11-04 |
| 1013521905 | Zachary Camden Grimes | Registered Nurse | 720 Eskenazi Avenute, Indianapolis, IN 46202 | 2020-09-08 |
| 1790314045 | Scott C Mitchell II | Student in an Organized Health Care Education/Training Program | Indiana University School of Medicine Dept of Neurosurg, 355 W. 16th St, Gh 5100, Indianapolis, IN 46202 | 2020-04-07 |
| 1053940676 | James Patrick Kelly Iv | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Dr., Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
| 1124657697 | Betsy Wilson Stevens | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Drive, Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
| 1093340580 | Brian T Edmonds | Social Worker | Sandra Eskenazi Mental Health Center, 1700 N Illinois St, Indianapolis, IN 46202 | 2020-03-05 |
| 1326683210 | Lindsay Nicole Rich | Nurse Practitioner | 1800 N Senate Ave, Indianapolis, IN 46202 | 2019-11-14 |
| 1427693670 | Ronald Mcdonald House Charities of Central Indiana | Voluntary or Charitable | 435 Limestone Street, Indianaplois, IN 46202 | 2019-11-12 |
| 1790344760 | Kirsten Denise Leaberry | Student in an Organized Health Care Education/Training Program | Iu Health Neuroscience Center, Goodman Hall, 355 West 16th Street, Indianapolis, IN 46202 | 2019-06-12 |
| 1679138093 | Chris Olson Jr. | Student in an Organized Health Care Education/Training Program | 1701 N. Senate Blvd, Ag012, Indianapolis, IN 46202 | 2019-05-02 |
| Find all providers in zip 46202 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124381751 | Robert W Godley II | Internal Medicine | Community Physicians of Indiana, Inc., 1402 E. County Line Rad, Indianapolis, IN 46227-0963 | 2012-06-19 |
| 1154550143 | Vitality Health Group | Internal Medicine | 1702 W Michigan St, Indianapolis, IN 46222-3983 | 2009-07-10 |
| 1689860819 | Mohammad M Marashdeh | Internal Medicine | 1400 N Ritter Ave Ste 520, Indianapolis, IN 46219-3052 | 2007-09-20 |
| 1346448305 | Mark Daniel Fisch | Internal Medicine | 1801 N Senate Boulevard, Suite 310, Indianapolis, IN 46202-1196 | 2007-07-10 |
| 1669550588 | Heart Partners of Indiana LLC | Internal Medicine | 8075 N Shadeland, #350, Indianapolis, IN 46250 | 2006-11-01 |
| 1821186933 | Bertram Anthony Graves | Internal Medicine | 3737 N. Meridian St., Suite 104, Indianapolis, IN 46208-4357 | 2006-10-11 |
| 1902860752 | Douglas P Zipes | Internal Medicine | 1801 N Capitol Ave, Indianapolis, IN 46202-1217 | 2006-04-17 |
| 1275532525 | Richard Hahn | Internal Medicine | 1207 Selkirk Ln, Indianapolis, IN 46260-1227 | 2005-07-19 |
| 1487651329 | Louis F. Janeira | Internal Medicine | 5330 E Stop 11 Rd, Indianapolis, IN 46237-6345 | 2005-07-07 |
| 1922560465 | Cind Care of In, LLC | Internal Medicine | 120 E Market St Ste 1271, Indianapolis, IN 46204-3250 | 2019-04-03 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46202 |
Please comment or provide details below to improve the information on TANYANAN TANAWUTTIWAT.
| 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.