Balancemd | |
3721 Rome Dr Suite A Lafayette IN 47905-4408 | |
(765) 807-7100 | |
(765) 807-7101 |
Full Name | Balancemd |
---|---|
Speciality | Psychiatry & Neurology |
Location | 3721 Rome Dr, Lafayette, Indiana |
Authorized Official Name and Position | Scott Sanders (PRESIDENT) |
Authorized Official Contact | 7658077100 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Balancemd 3721 Rome Dr Suite A Lafayette IN 47905-4408 Ph: (765) 807-7100 | Balancemd 3721 Rome Dr Suite A Lafayette IN 47905-4408 Ph: (765) 807-7100 |
NPI Number | 1104989011 |
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Provider Enumeration Date | 12/19/2006 |
Last Update Date | 10/02/2019 |
Medicare PECOS PAC ID | 2769588151 |
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Medicare Enrollment ID | O20070501000512 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104989011 | NPI | - | NPPES |
000000507081 | Other | IN | ANTHEM |
10019219 | Other | ENCORE | |
9239622 | Other | CIGNA | |
DF9084 | Other | IN | MEDICARE RR |
5776298 | Other | AETNA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | 01045654 (Indiana) | Primary |
Provider Name | Scott K Sanders |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1902800576 PECOS PAC ID: 2668578063 Enrollment ID: I20070501000538 |
Provider Name | Sandra M Bratton |
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Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1407815715 PECOS PAC ID: 2668568940 Enrollment ID: I20071017000917 |
Provider Name | Michelle A Koley |
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Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1851593578 PECOS PAC ID: 5597834846 Enrollment ID: I20080513000487 |
Provider Name | Ashly N Gray |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1801254081 PECOS PAC ID: 6103118963 Enrollment ID: I20160714001731 |
Provider Name | Connor Slavich |
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Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1548876428 PECOS PAC ID: 7810362548 Enrollment ID: I20230909000091 |
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