Lily Kwatampora (NPI# 1407182041, PAC ID# 0547559536) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ENDOCRINOLOGY.
| Nation Provider ID (NPI) | 1407182041 |
| PAC ID by PECOS | 0547559536 |
| Professional Enrollment ID | I20160513001668 |
| Full Name | Lily Kwatampora |
| Organization Legal Name | LUTHERAN MEDICAL GROUP LLC |
| Address |
5717 S Anthony Blvd Suite 200 Fort Wayne IN 46806-3300 |
| Phone Number | 2604252680 |
| Gender | F |
| Graduation Year | 2003 |
| Primary Specialty | ENDOCRINOLOGY |
| Group Practice PAC ID | 4981751617 |
| Number of Group Practice Members | 211 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150017 | LUTHERAN HOSPITAL OF INDIANA |
| 150047 | ST JOSEPH HOSPITAL |
| 150021 | PARKVIEW REGIONAL MEDICAL CENTER |
| 150133 | KOSCIUSKO COMMUNITY HOSPITAL |
| 360071 | VAN WERT COUNTY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 5717 S Anthony Blvd, Suite 200, Fort Wayne, IN 46806-3300 | 2604252680 | LUTHERAN MEDICAL GROUP LLC |
| Organization Legal Name | LUTHERAN MEDICAL GROUP LLC |
| Physicians | 216 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melissa Stemen | Nurse Practitioner | Lutheran Medical Group LLC | 11115 Lima Rd, Fort Wayne, IN 46818-9536 |
| David C. Cronin | General Surgery | Lutheran Medical Group LLC | 2516 E Dupont Rd, Fort Wayne, IN 46825-1608 |
| George Steven Kalesperis | Family Medicine | Lutheran Medical Group LLC | 6511 E State Blvd, Fort Wayne, IN 46815-7026 |
| Ann R. Moore | Nurse Practitioner | Lutheran Medical Group LLC | 303 S Main St, Bluffton Regional Hospital, Bluffton, IN 46714-2503 |
| Stephanie A Clouse | Nurse Practitioner | Lutheran Medical Group LLC | 7916 W Jefferson Blvd, Fort Wayne, IN 46804-4140 |
| Nicole Sanderson | Nurse Practitioner | Lutheran Medical Group LLC | 3534 Brooklyn Ave, Fort Wayne, IN 46809-1361 |
| Kanika Jaggi | Family Medicine | Lutheran Medical Group LLC | 5717 S Anthony Blvd, Suite 800, Fort Wayne, IN 46806-3393 |
| Ibad Ul-haq Farooqui | Family Medicine | Lutheran Medical Group LLC | 402 E Main St, Fort Wayne, IN 46802-1910 |
| Christine Springer | Nurse Practitioner | Lutheran Medical Group LLC | 10429 Hosler Rd, Leo, IN 46765-9739 |
| Leia A Becktell | Nurse Practitioner | Lutheran Medical Group LLC | 7952 W Jefferson Blvd, The Orthopedic Hospital, Fort Wayne, IN 46804-4140 |
| Street Address |
5717 S ANTHONY BLVD SUITE 200 |
| City | FORT WAYNE |
| State | IN |
| Zip | 46806-3300 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kanika Jaggi | Family Medicine | Lutheran Medical Group LLC | 5717 S Anthony Blvd, Suite 800, Fort Wayne, IN 46806-3393 |
| Richard M Hilker | Podiatry | Richard M. Hilker, Dpm, P.C. | 5717 S Anthony Blvd, Suite 600, Fort Wayne, IN 46806-3394 |
| Shelby Ann Kenner | Family Medicine | Lutheran Medical Group LLC | 5717 S Anthony Blvd, Suite 100, Fort Wayne, IN 46806-3303 |
| Dale H Aeschliman | Family Medicine | 5717 S Anthony Blvd, Suite 600, Fort Wayne, IN 46806-3394 | |
| Hector F Perez | Family Medicine | 5717 S Anthony Blvd, Suite 500, Fort Wayne, IN 46806-3300 | |
| Loretta L Bazur-persing | Nurse Practitioner | Lutheran Medical Group LLC | 5717 S Anthony Blvd, Suite 200, Fort Wayne, IN 46806-3300 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melinda Davis | Clinical Social Worker | Park Center Inc | 2700 Lafayette St, Fort Wayne, IN 46806-1100 |
| Benny Fair Jr. | Podiatry | 2700 Lafayette St, Suite 100, Fort Wayne, IN 46806-1100 | |
| Deborah S Baker | Nurse Practitioner | Park Center Inc | 2700 Lafayette St, Fort Wayne, IN 46806-1100 |
| City | FORT WAYNE |
| Zip Code | 46806 |
| Specialty | ENDOCRINOLOGY |
| City + Specialty | FORT WAYNE + ENDOCRINOLOGY |
Please comment or provide details below to improve the information on Lily Kwatampora.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.