Audette Johnson (NPI# 1184872566, PAC ID# 8527128578) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1184872566 |
| PAC ID by PECOS | 8527128578 |
| Professional Enrollment ID | I20111115000262 |
| Full Name | Audette Johnson |
| Organization Legal Name | IMPACT PHYSICIAN GROUP INDIANA LLC |
| Address |
1700 W 10th St Indianapolis IN 46222-3802 |
| Phone Number | 3176364400 |
| Gender | F |
| Graduation Year | 2007 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 6608111026 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150048 | REID HOSPITAL & HEALTH CARE SERVICES |
| Address | Phone | Organization |
|---|---|---|
| 1700 W 10th St, Indianapolis, IN 46222-3802 | 3176364400 | IMPACT PHYSICIAN GROUP INDIANA LLC |
| 1700 W 10th St, Indianapolis, IN 46222-3802 | GASTRO MD LLC | |
| 4141 Shore Dr, Indianapolis, IN 46254-2607 | 3173292000 | IMPACT PHYSICIAN GROUP INDIANA LLC |
| Organization Legal Name | IMPACT PHYSICIAN GROUP INDIANA LLC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Yulia Yurevna Abair | Nurse Practitioner | Impact Physician Group Indiana LLC | 1121 E Lasalle Ave, South Bend, IN 46617-3321 |
| Agnes Idahosa Asamah | Nurse Practitioner | Impact Physician Group Indiana LLC | 3017 Valley Farms Rd, Indianapolis, IN 46214-1513 |
| Mazhar Khan | Family Medicine | Impact Physician Group Indiana LLC | 1700 W 10th St, Indianapolis, IN 46222-3802 |
| Syed W Moazzem | Rheumatology | Impact Physician Group Indiana LLC | 281 S County Rd 200, Connersville, IN 47331-8220 |
| Zubair Khan | Internal Medicine | Impact Physician Group Indiana LLC | 1700 W 10th St, Indianapolis, IN 46222-3802 |
| Lisa Sue Jones | Nurse Practitioner | Impact Physician Group Indiana LLC | 1700 W 10th St, Indianapolis, IN 46222-3802 |
| Yonna Allen | Nurse Practitioner | Impact Physician Group Indiana LLC | 3017 Valley Farms Rd, Indianapolis, IN 46214-1513 |
| Sinikweyinkosi Mabandla | Nurse Practitioner | Impact Physician Group Indiana LLC | 4141 Shore Dr, Indianapolis, IN 46254-2607 |
| Street Address |
1700 W 10TH ST |
| City | INDIANAPOLIS |
| State | IN |
| Zip | 46222-3802 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mazhar Khan | Family Medicine | Impact Physician Group Indiana LLC | 1700 W 10th St, Indianapolis, IN 46222-3802 |
| Zubair Khan | Internal Medicine | Impact Physician Group Indiana LLC | 1700 W 10th St, Indianapolis, IN 46222-3802 |
| Lisa Sue Jones | Nurse Practitioner | Impact Physician Group Indiana LLC | 1700 W 10th St, Indianapolis, IN 46222-3802 |
| Saif M Choudhury | Family Medicine | Gastro Md LLC | 1700 W 10th St, Indianapolis, IN 46222-3802 |
| Anil V Yadav | Cardiovascular Disease (cardiology) | In Charge Medical Professionals LLC | 1700 W 10th St, Indianapolis, IN 46222-3802 |
| Robert Albert Strawbridge | Pulmonary Disease | Knd Development 59 LLC | 1700 W 10th St, Indianapolis, IN 46222-3802 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert C Rauzi | Anesthesiology | Westview Anesthesia Group LLC | 3630 Guion Rd, Indianapolis, IN 46222-1616 |
| Yonas Adal | Anesthesiology | Westview Anesthesia Group LLC | 3630 Guion Rd, Indianapolis, IN 46222-1616 |
| Ronald L Gemma | Family Medicine | Community Physicians of Indiana Inc | 3750 Guion Rd, Suite 185, Indianapolis, IN 46222-1669 |
| Sheron M Randolph | Family Medicine | Community Physicians of Indiana Inc | 3750 Guion Rd, Suite 185, Indianapolis, IN 46222-1669 |
| Arthur S Roberts Jr. | Oral Surgery | 3750 Guion Rd, Suite 250, Indianapolis, IN 46222-1669 | |
| Todd E Midla | Orthopedic Surgery | 3660 Guion Rd, Suite 230, Indianapolis, IN 46222-1691 | |
| Kelsey E Doll | Registered Dietitian Or Nutrition Professional | Eskenazi Medical Group Inc | 2802 N Lafayette Rd, 13 Eskenazi Medical Grp, Indianapolis, IN 46222-2112 |
| Michael F Kosir | Optometry | City Optical Co Inc | 2835 Lafayette Rd, Indianapolis, IN 46222-2147 |
| Jamz M Porzio | Optometry | City Optical Co Inc | 2835 Lafayette Rd, Indianapolis, IN 46222-2147 |
| David J Seay | Optometry | City Optical Co Inc | 2835 Lafayette Rd, Indianapolis, IN 46222-2147 |
| Find all physicians in zip 46222 | |||
| City | INDIANAPOLIS |
| Zip Code | 46222 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | INDIANAPOLIS + NURSE PRACTITIONER |
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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.