Matthew S Blackmon (NPI# 1073970521, PAC ID# 1951607274) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CHIROPRACTIC.
| Nation Provider ID (NPI) | 1073970521 |
| PAC ID by PECOS | 1951607274 |
| Professional Enrollment ID | I20160314001028 |
| Full Name | Matthew S Blackmon |
| Organization Legal Name | CENTERS FOR PAIN CONTROL, INC |
| Address |
204 Legacy Plaza W Laporte IN 46350-5285 |
| Phone Number | 2193267246 |
| Gender | M |
| Medical School | LIFE CHIROPRACTIC COLLEGE |
| Graduation Year | 2015 |
| Primary Specialty | CHIROPRACTIC |
| Group Practice PAC ID | 7416019450 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150006 | LA PORTE HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 204 Legacy Plaza W, Laporte, IN 46350-5285 | 2193267246 | CENTERS FOR PAIN CONTROL, INC |
| Organization Legal Name | CENTERS FOR PAIN CONTROL, INC |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Samara Ruder | Nurse Practitioner | Centers for Pain Control, Inc | 11420 Broadway, Crown Point, IN 46307-7106 |
| Tyler Michael Gress | Chiropractic | Centers for Pain Control, Inc | 1928 45th Ave, Munster, IN 46321-3917 |
| Lakia S Brown | Chiropractic | Centers for Pain Control, Inc | 204 Legacy Plaza W, Laporte, IN 46350-5285 |
| Keerthi D Prasad | Diagnostic Radiology | Centers for Pain Control, Inc | 2211 Roosevelt Rd, Valparaiso, IN 46383-2748 |
| Rohit S Puranik | Anesthesiology | Centers for Pain Control, Inc | 2205 Roosevelt Rd, Valparaiso, IN 46383-2748 |
| Chetan S Puranik | Anesthesiology | Centers for Pain Control, Inc | 1924 45th St, Munster, IN 46321-3917 |
| Julie Ann Stein | Nurse Practitioner | Centers for Pain Control, Inc | 201 Main St, Suite A, Hobart, IN 46342-4439 |
| Simon G Ho | Pain Management | Centers for Pain Control, Inc | 201 Main St, Hobart, IN 46342-4439 |
| Jennifer Razey | Chiropractic | Centers for Pain Control, Inc | 204 Legacy Plaza W, Laporte, IN 46350-5285 |
| Phoxay Phetthongsy | Chiropractic | Centers for Pain Control, Inc | 1928 45th Ave, Munster, IN 46321-3917 |
| Street Address |
204 LEGACY PLAZA W |
| City | LAPORTE |
| State | IN |
| Zip | 46350-5285 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lakia S Brown | Chiropractic | Centers for Pain Control, Inc | 204 Legacy Plaza W, Laporte, IN 46350-5285 |
| Jennifer Razey | Chiropractic | Centers for Pain Control, Inc | 204 Legacy Plaza W, Laporte, IN 46350-5285 |
| Sitasadaphone P Phetchamphone | Chiropractic | Centers for Pain Control, Inc | 204 Legacy Plaza W, Laporte, IN 46350-5285 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kayla Rae Nebelsick | Obstetrics/gynecology | Franciscan Physician Network | 309 W Johnson Rd, La Porte, IN 46350-1943 |
| Nancy Hoback | Clinical Social Worker | 245 W Johnson Rd, Suite 2, La Porte, IN 46350-2026 | |
| Amer Mahmud Kazi | Neurology | 286 W Johnson Rd E, Indiana Pain and Spine Clinic, Laporte, IN 46350-2060 | |
| Mary Beth Schramlin | Clinical Social Worker | 2626 N State Rd 39, Suite 4, La Porte, IN 46350-2074 | |
| Mark C Grant | Chiropractic | 611 Pine Lake Ave, Laporte, IN 46350-2318 | |
| Diana M Correll | Physician Assistant | La Porte Clinic Company LLC | 304 Detroit St, La Porte, IN 46350-2497 |
| Mackenzie Jacquelyn Blust | Physician Assistant | La Porte Clinic Company LLC | 304 Detroit St, La Porte, IN 46350-2497 |
| Neil W Wangstrom | Otolaryngology | La Porte Clinic Company LLC | 304 Detroit St, La Porte, IN 46350-2497 |
| Jessica L Barr | Qualified Audiologist | La Porte Clinic Company LLC | 304 Detroit St, La Porte, IN 46350-2497 |
| Jessie B Batchelor | Audiologist | La Porte Clinic Company LLC | 304 Detroit St, La Porte, IN 46350-2497 |
| Find all physicians in zip 46350 | |||
| City | LAPORTE |
| Zip Code | 46350 |
| Specialty | CHIROPRACTIC |
| City + Specialty | LAPORTE + CHIROPRACTIC |
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| 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.