Kunteera Vachirasomboon Tarin (NPI# 1740411305, PAC ID# 1355496712) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1740411305 |
| PAC ID by PECOS | 1355496712 |
| Professional Enrollment ID | I20171003005151 |
| Full Name | Kunteera Vachirasomboon Tarin |
| Organization Legal Name | INDIANA SPORTS AND MEDICAL SCIENCE INSTITUTE, PC |
| Address |
11275 Delaware Pkwy Suite A Crown Point IN 46307-7812 |
| Phone Number | 2197798735 |
| Gender | F |
| Medical School | INDIANA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2002 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | PEDIATRIC MEDICINE |
| Group Practice PAC ID | 2860662517 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150126 | FRANCISCAN HEALTH CROWN POINT |
| Address | Phone | Organization |
|---|---|---|
| 11275 Delaware Pkwy, Suite A, Crown Point, IN 46307-7812 | 2197798735 | INDIANA SPORTS AND MEDICAL SCIENCE INSTITUTE, PC |
| Organization Legal Name | INDIANA SPORTS AND MEDICAL SCIENCE INSTITUTE, PC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Colleen M Lustina | Nurse Practitioner | Indiana Sports and Medical Science Institute, PC | 11275 Delaware Pkwy, Suite A, Crown Point, IN 46307-7812 |
| Timothy J Mullally | Family Medicine | Indiana Sports and Medical Science Institute, PC | 11275 Delaware Pkwy, Suite A, Crown Point, IN 46307-7812 |
| Lauren C Parker | Nurse Practitioner | Indiana Sports and Medical Science Institute, PC | 11275 Delaware Pkwy, Suite A, Crown Point, IN 46307-7812 |
| Lisa D Mullally | Family Medicine | Indiana Sports and Medical Science Institute, PC | 11275 Delaware Pkwy, Suite A, Crown Point, IN 46307-7812 |
| Susan L Blensdorf | Nurse Practitioner | Indiana Sports and Medical Science Institute, PC | 11275 Delaware Pkwy, Suite A, Crown Point, IN 46307-7812 |
| Street Address |
11275 DELAWARE PKWY SUITE A |
| City | CROWN POINT |
| State | IN |
| Zip | 46307-7812 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eric Clark Deakins | Physical Therapy | Ivyrehab Physical Therapy Pllc | 11275 Delaware Pkwy, Suite B, Crown Point, IN 46307-7812 |
| Christena S Wichowsky | Physical Therapy | Ivyrehab Physical Therapy Pllc | 11275 Delaware Pkwy, Suite B, Crown Point, IN 46307-7812 |
| Kevin T Sanborn | Physical Therapy | Ivyrehab Physical Therapy Pllc | 11275 Delaware Pkwy, Suite B, Crown Point, IN 46307-7812 |
| Colleen M Lustina | Nurse Practitioner | Indiana Sports and Medical Science Institute, PC | 11275 Delaware Pkwy, Suite A, Crown Point, IN 46307-7812 |
| Timothy J Mullally | Family Medicine | Indiana Sports and Medical Science Institute, PC | 11275 Delaware Pkwy, Suite A, Crown Point, IN 46307-7812 |
| Lauren C Parker | Nurse Practitioner | Indiana Sports and Medical Science Institute, PC | 11275 Delaware Pkwy, Suite A, Crown Point, IN 46307-7812 |
| Lisa D Mullally | Family Medicine | Indiana Sports and Medical Science Institute, PC | 11275 Delaware Pkwy, Suite A, Crown Point, IN 46307-7812 |
| Larry H Hall | Physical Therapy | Ivyrehab Physical Therapy Pllc | 11275 Delaware Pkwy, Suite B, Crown Point, IN 46307-7812 |
| Charles T. Damitz | Physical Therapy | Ivyrehab Physical Therapy, Pllc | 11275 Delaware Pkwy, Suite B, Crown Point, IN 46307-7812 |
| Susan L Blensdorf | Nurse Practitioner | Indiana Sports and Medical Science Institute, PC | 11275 Delaware Pkwy, Suite A, Crown Point, IN 46307-7812 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William A Zato | Family Medicine | Advanced Care Medical Specialists PC | 1555 S Main St, Symphony of Crown Point, Crown Point, IN 46307-0114 |
| Kathleen J Decorte | Nurse Practitioner | Allergy Asthma Care P.C. | 5521 W Lincoln Hwy 100, Crown Point, IN 46307-1098 |
| Rebekah Jennifer Vega | Nurse Practitioner | Midwest Express Care 4 LLC | 5521 W Lincoln Hwy, Suite 1a, Crown Point, IN 46307-1098 |
| Julie Ann Derosa | Family Practice | Aberdeen Ventures, Ltd. | 5521 W Lincoln Hwy 1a, Immediate Care Center, Crown Point, IN 46307-1098 |
| Miyako S Streeter | Nurse Practitioner | Midwest Express Care 4 LLC | 5521 W Lincoln Hwy, Suite 1a, Crown Point, IN 46307-1098 |
| Dana Joy Hiskes | Nurse Practitioner | Midwest Express Care 4 LLC | 5521 W Lincoln Hwy, Suite 1a, Crown Point, IN 46307-1098 |
| Kenneth W Blumenthal | Allergy/immunology | Allergy Asthma Care P.C. | 5521 W Lincoln Hwy 100, Crown Point, IN 46307-1098 |
| Margaret Bazarko | Qualified Speech Language Pathologist | Allergy Asthma Care P.C. | 5521 W Lincoln Hwy 100, Crown Point, IN 46307-1098 |
| Kerry Ann Kanaley | Nurse Practitioner | Midwest Express Care 4 LLC | 5521 W Lincoln Hwy, Suite 1a, Crown Point, IN 46307-1098 |
| Akeela Benson | Nurse Practitioner | Midwest Express Care 4 LLC | 5521 W Lincoln Hwy, Suite 1a, Crown Point, IN 46307-1098 |
| Find all physicians in zip 46307 | |||
| City | CROWN POINT |
| Zip Code | 46307 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | CROWN POINT + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Kunteera Vachirasomboon Tarin.
| 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.