| Jwm Neurology Pc | |
|
6983 Hillsdale Ct Indianapolis IN 46250-2054 | |
| (317) 849-8350 | |
| (317) 576-6311 |
| Full Name | Jwm Neurology Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6983 Hillsdale Ct, Indianapolis, Indiana |
| Authorized Official Name and Position | William D Earwood (CFO/CIO) |
| Authorized Official Contact | 3173082828 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jwm Neurology Pc Po Box 2152 Indianapolis IN 46206-2152 Ph: (317) 308-2828 | Jwm Neurology Pc 6983 Hillsdale Ct Indianapolis IN 46250-2054 Ph: (317) 849-8350 |
| NPI Number | 1740377803 |
|---|---|
| Provider Enumeration Date | 10/09/2006 |
| Last Update Date | 12/05/2023 |
| Certification Date | 12/05/2023 |
| Medicare PECOS PAC ID | 6709868870 |
|---|---|
| Medicare Enrollment ID | O20040602001359 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740377803 | NPI | - | NPPES |
| 100218760 | Medicaid | IN | |
| CJ9849 | Other | MEDICARE RR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Donald Douglas Strobel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881698454 PECOS PAC ID: 9638074115 Enrollment ID: I20031208000101 |
| Provider Name | Jeffrey Hilburn |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962409805 PECOS PAC ID: 1658280946 Enrollment ID: I20040416000643 |
| Provider Name | Raymond J Loffer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235133802 PECOS PAC ID: 2062495997 Enrollment ID: I20040610001337 |
| Provider Name | Leo T Dambrosio |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255335949 PECOS PAC ID: 9830174127 Enrollment ID: I20040621001708 |
| Provider Name | Meredith W Cousin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952305534 PECOS PAC ID: 7618939919 Enrollment ID: I20041029000189 |
| Provider Name | Gina C Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669474631 PECOS PAC ID: 2961466131 Enrollment ID: I20041117000428 |
| Provider Name | Naraharisetty N Rau |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154325710 PECOS PAC ID: 4486602109 Enrollment ID: I20050110000822 |
| Provider Name | Craig E Herrman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750385332 PECOS PAC ID: 3274589981 Enrollment ID: I20050325000242 |
| Provider Name | Margaret L Frazer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871605436 PECOS PAC ID: 9133176852 Enrollment ID: I20050405000933 |
| Provider Name | Kevin Joseph Puzio |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194722843 PECOS PAC ID: 2668467929 Enrollment ID: I20060206000749 |
| Provider Name | Barbara L Bowers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407851033 PECOS PAC ID: 6608973839 Enrollment ID: I20070522000481 |
| Provider Name | Katherine T Kobza |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447254016 PECOS PAC ID: 1557446119 Enrollment ID: I20080307000136 |
| Provider Name | Michelle L Carlos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962668301 PECOS PAC ID: 3779659024 Enrollment ID: I20080910000291 |
| Provider Name | Cynthia K Mcgarvey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1134335870 PECOS PAC ID: 7810063104 Enrollment ID: I20080911000007 |
| Provider Name | Keith W Cushing |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043437395 PECOS PAC ID: 8527135516 Enrollment ID: I20080917000025 |
| Provider Name | Sridhar Jatla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891704565 PECOS PAC ID: 1658452974 Enrollment ID: I20081017000321 |
| Provider Name | Kuimil K Mohan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407850068 PECOS PAC ID: 5991863508 Enrollment ID: I20081027000580 |
| Provider Name | Karen L Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881866416 PECOS PAC ID: 9537223946 Enrollment ID: I20090130000081 |
| Provider Name | Adam J Fisch |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548366024 PECOS PAC ID: 6709937733 Enrollment ID: I20090701000634 |
| Provider Name | Charles Howe |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1568493096 PECOS PAC ID: 9638219975 Enrollment ID: I20091218000032 |
| Provider Name | Michael A Sermersheim |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770587487 PECOS PAC ID: 9830232537 Enrollment ID: I20100203000393 |
| Provider Name | Jennifer M Vivio |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447254008 PECOS PAC ID: 2668515396 Enrollment ID: I20100203000719 |
| Provider Name | Kristi K George |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770587479 PECOS PAC ID: 0244132504 Enrollment ID: I20100204000453 |
| Provider Name | David A Glander |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669476362 PECOS PAC ID: 5991848442 Enrollment ID: I20100205000036 |
| Provider Name | Patrick E Matoole |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588668149 PECOS PAC ID: 0749323293 Enrollment ID: I20100205000108 |
| Provider Name | Maria Angeline Diokno |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649276379 PECOS PAC ID: 1759425895 Enrollment ID: I20100212000534 |
| Provider Name | Caroline Barbara Stevens |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992028039 PECOS PAC ID: 8628105905 Enrollment ID: I20100419000024 |
| Provider Name | Keith Ridel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053528935 PECOS PAC ID: 8022140409 Enrollment ID: I20100720001079 |
| Provider Name | David A Josephson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871597559 PECOS PAC ID: 7810979994 Enrollment ID: I20100804000793 |
| Provider Name | Ganesh T Ghooray |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144227042 PECOS PAC ID: 3971627530 Enrollment ID: I20100902001068 |
| Provider Name | Larry L Blankenship |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407947807 PECOS PAC ID: 9537139571 Enrollment ID: I20100909000631 |
| Provider Name | Christopher P Rocco |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508957952 PECOS PAC ID: 5991775934 Enrollment ID: I20100909000905 |
| Provider Name | Amy L Frank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740594167 PECOS PAC ID: 4183817711 Enrollment ID: I20101015000000 |
| Provider Name | Sara Lynn Schrader |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558337592 PECOS PAC ID: 4587820329 Enrollment ID: I20120724000447 |
| Provider Name | Brian T Paquette |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952370397 PECOS PAC ID: 2860422342 Enrollment ID: I20121004000197 |
| Provider Name | Chandra S Brahmachari |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881885655 PECOS PAC ID: 9436314358 Enrollment ID: I20130905000084 |
| Provider Name | Kiran Ivaturi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437479615 PECOS PAC ID: 2163668450 Enrollment ID: I20140514000427 |
| Provider Name | Kristyn Jennifer Tekulve |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902070089 PECOS PAC ID: 4183862410 Enrollment ID: I20140515002274 |
| Provider Name | Marc L Cohen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942461165 PECOS PAC ID: 8325287378 Enrollment ID: I20140519000091 |
| Provider Name | Monica E Mazda |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770718116 PECOS PAC ID: 0143466391 Enrollment ID: I20140801001037 |
| Provider Name | Andrea Marie Randall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821409467 PECOS PAC ID: 4981920261 Enrollment ID: I20150304000276 |
| Provider Name | Marcus J Magnussen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1457678187 PECOS PAC ID: 3375854565 Enrollment ID: I20150615000976 |
| Provider Name | Matthew G Gentry |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558654913 PECOS PAC ID: 4183860562 Enrollment ID: I20160523001946 |
| Provider Name | Kofi Del Quist |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295933349 PECOS PAC ID: 1254406481 Enrollment ID: I20170619001739 |
| Provider Name | Teresa E Kirisits |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619485786 PECOS PAC ID: 4385905926 Enrollment ID: I20180222002961 |
| Provider Name | Corie Lynn Connor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669980280 PECOS PAC ID: 4789932419 Enrollment ID: I20180813000478 |
| Provider Name | Seth H Lichtenstein |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598761041 PECOS PAC ID: 6507805181 Enrollment ID: I20200417002464 |
| Provider Name | Rahul Dilip Abhyankar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659768505 PECOS PAC ID: 2961824289 Enrollment ID: I20200615002553 |
| Provider Name | Kimberly J Ackerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598437071 PECOS PAC ID: 0042609497 Enrollment ID: I20211105001139 |
| Provider Name | Hannah Jeanne Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356093504 PECOS PAC ID: 5799170023 Enrollment ID: I20220323000179 |
| Provider Name | Namratha Sandella |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659804318 PECOS PAC ID: 0244509271 Enrollment ID: I20220427000688 |
| Provider Name | Nicholas Stephen Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386383040 PECOS PAC ID: 7113308784 Enrollment ID: I20220714001213 |
| Provider Name | Casey Ann Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770216756 PECOS PAC ID: 6507221322 Enrollment ID: I20230501002450 |
| Provider Name | Danielle Nicole Presley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518665892 PECOS PAC ID: 1658736301 Enrollment ID: I20230502001384 |
| Provider Name | Elizabeth Anne Bancroft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871292482 PECOS PAC ID: 8628433380 Enrollment ID: I20230502001556 |
| Provider Name | Andrea Lynn Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477294627 PECOS PAC ID: 1759747439 Enrollment ID: I20230523000937 |
| Provider Name | Lea N Chhiba |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215598248 PECOS PAC ID: 6800121849 Enrollment ID: I20230705002883 |
| Provider Name | Melissa Ann Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366217390 PECOS PAC ID: 8022467174 Enrollment ID: I20231214000981 |
| Provider Name | Madison N Sheline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376319954 PECOS PAC ID: 4385094150 Enrollment ID: I20231220002841 |
| Provider Name | Linnessa S Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023896552 PECOS PAC ID: 5294171138 Enrollment ID: I20240313003134 |
| Provider Name | Runjhun Bhatia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427440718 PECOS PAC ID: 0840632733 Enrollment ID: I20240523001506 |
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