4c Health | |
1000 N Broadway Peru IN 46970-1070 | |
(574) 722-5151 | |
(574) 739-1414 |
Full Name | 4c Health |
---|---|
Speciality | Clinic/Center |
Location | 1000 N Broadway, Peru, Indiana |
Authorized Official Name and Position | Carrie Ann Cadwell (CEO) |
Authorized Official Contact | 5747225151 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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4c Health 2355 S Business 31 Peru IN 46970-8985 Ph: (574) 722-5151 | 4c Health 1000 N Broadway Peru IN 46970-1070 Ph: (574) 722-5151 |
NPI Number | 1972545945 |
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Provider Enumeration Date | 06/12/2006 |
Last Update Date | 09/18/2024 |
Certification Date | 09/18/2024 |
Medicare PECOS PAC ID | 2163334277 |
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Medicare Enrollment ID | O20031105000480 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972545945 | NPI | - | NPPES |
100464740 | Medicaid | IN |
Provider Name | Jean A Halfast |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1851329593 PECOS PAC ID: 0042289290 Enrollment ID: I20040925000052 |
Provider Name | Jane N Abbott Rider |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508800608 PECOS PAC ID: 3870664410 Enrollment ID: I20080625000346 |
Provider Name | Richard C Voorhees |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1407047186 PECOS PAC ID: 9537231147 Enrollment ID: I20080626000214 |
Provider Name | Kathleen M Miller |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1790883528 PECOS PAC ID: 6103976659 Enrollment ID: I20090604000281 |
Provider Name | Wonda F Elmore |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053546556 PECOS PAC ID: 7315084092 Enrollment ID: I20091029000082 |
Provider Name | Matthew Gregory Grant |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1609074640 PECOS PAC ID: 4587793351 Enrollment ID: I20100603000927 |
Provider Name | Steven M Carney |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1649208026 PECOS PAC ID: 3870617467 Enrollment ID: I20100903000157 |
Provider Name | James P Noll |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1730124264 PECOS PAC ID: 3274658448 Enrollment ID: I20100910000710 |
Provider Name | John W George |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1528099892 PECOS PAC ID: 0749472629 Enrollment ID: I20101011000557 |
Provider Name | Christina J Waddups |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1770750473 PECOS PAC ID: 7214190842 Enrollment ID: I20120518000226 |
Provider Name | Mallery R Neff |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1528387628 PECOS PAC ID: 2860648078 Enrollment ID: I20120803000217 |
Provider Name | Qun Wu |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1184792020 PECOS PAC ID: 9133383516 Enrollment ID: I20130218000256 |
Provider Name | Crystal Ridenour |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346671997 PECOS PAC ID: 8123245479 Enrollment ID: I20140808001832 |
Provider Name | Aimee Dershowitz |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1154762664 PECOS PAC ID: 1153540786 Enrollment ID: I20140915000914 |
Provider Name | Bertold Stover |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1225469877 PECOS PAC ID: 9830416221 Enrollment ID: I20150324000552 |
Provider Name | Sabrina Straub |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1881029163 PECOS PAC ID: 4183944275 Enrollment ID: I20150513000189 |
Provider Name | Deborah A Davidson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063813178 PECOS PAC ID: 8426270935 Enrollment ID: I20170814000942 |
Provider Name | Nubia Mcvey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598280968 PECOS PAC ID: 0547526147 Enrollment ID: I20171115001660 |
Provider Name | Mark R Lentz |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548773492 PECOS PAC ID: 3971861287 Enrollment ID: I20171214001282 |
Provider Name | Casey Lynn Hill |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588153746 PECOS PAC ID: 4587928718 Enrollment ID: I20180515003254 |
Provider Name | Christine M Knapp |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1952637308 PECOS PAC ID: 4385816164 Enrollment ID: I20190102002919 |
Provider Name | Letecia D Timmel |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1225473218 PECOS PAC ID: 4284970757 Enrollment ID: I20190104001634 |
Provider Name | Amy Herron-miller |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366616419 PECOS PAC ID: 4284964834 Enrollment ID: I20190924002274 |
Provider Name | Matthew Jason Tanner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396395067 PECOS PAC ID: 1052743382 Enrollment ID: I20191107001050 |
Provider Name | Sara Elisabeth Spence |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649814872 PECOS PAC ID: 8426480922 Enrollment ID: I20191121003190 |
Provider Name | Jerry J Fry |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1881861714 PECOS PAC ID: 1557791696 Enrollment ID: I20200414000471 |
Provider Name | Carrie Lynne Helle |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184988388 PECOS PAC ID: 6002138344 Enrollment ID: I20211201002127 |
Provider Name | Lauren Whitney Merrell |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1194409482 PECOS PAC ID: 4284095803 Enrollment ID: I20230731000374 |
Provider Name | Terry L. Schrock |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1427127703 PECOS PAC ID: 3577901701 Enrollment ID: I20240405002470 |
Provider Name | Kenneth Jay Zumbaugh |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1801824842 PECOS PAC ID: 0143668319 Enrollment ID: I20240406000362 |
Provider Name | Joshua David Wilson |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1194478776 PECOS PAC ID: 4880032085 Enrollment ID: I20240408001622 |
Provider Name | Bridget Lee Spinner-baker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306601265 PECOS PAC ID: 3779924378 Enrollment ID: I20240514002372 |
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