| Paradigm Living Concepts, Llc | |
|
8904 Bash St Ste B Indianapolis IN 46256-1286 | |
| (317) 735-6001 | |
| Not Available |
| Full Name | Paradigm Living Concepts, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 8904 Bash St Ste B, Indianapolis, Indiana |
| Authorized Official Name and Position | Jeffrey Noah Jarecki (PRESIDENT & CEO) |
| Authorized Official Contact | 3177356001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paradigm Living Concepts, Llc 8904 Bash St Ste B Indianapolis IN 46256-1286 Ph: (317) 735-6001 | Paradigm Living Concepts, Llc 8904 Bash St Ste B Indianapolis IN 46256-1286 Ph: (317) 735-6001 |
| NPI Number | 1679194773 |
|---|---|
| Provider Enumeration Date | 04/29/2020 |
| Last Update Date | 04/29/2020 |
| Certification Date | 04/29/2020 |
| Medicare PECOS PAC ID | 1355575424 |
|---|---|
| Medicare Enrollment ID | O20131113001498 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679194773 | NPI | - | NPPES |
| Provider Name | Melissa Y Brock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598931040 PECOS PAC ID: 0547313777 Enrollment ID: I20090805000146 |
| Provider Name | Tara N Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992013957 PECOS PAC ID: 6608060587 Enrollment ID: I20101104000920 |
| Provider Name | Danielle Lee Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598074692 PECOS PAC ID: 0446446173 Enrollment ID: I20101120000125 |
| Provider Name | Kimberely Anne Contreraz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669770855 PECOS PAC ID: 4688858467 Enrollment ID: I20110404000452 |
| Provider Name | Stacey M Engel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871900498 PECOS PAC ID: 4284853813 Enrollment ID: I20140915000811 |
| Provider Name | Linda S Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164823985 PECOS PAC ID: 5092934075 Enrollment ID: I20150922000286 |
| Provider Name | Michael Allen Hiland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316317811 PECOS PAC ID: 9931418241 Enrollment ID: I20151027000927 |
| Provider Name | Tammra K Mallory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750757076 PECOS PAC ID: 7214243211 Enrollment ID: I20170823001857 |
| Provider Name | Terri Girt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700375243 PECOS PAC ID: 4183989817 Enrollment ID: I20180531000101 |
| Provider Name | Cassandra L Farmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023504354 PECOS PAC ID: 9335497494 Enrollment ID: I20180806001991 |
| Provider Name | Mary Katherine Molloy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114407699 PECOS PAC ID: 3678825049 Enrollment ID: I20181012000951 |
| Provider Name | Tiffany J Kirchner |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1255639001 PECOS PAC ID: 1759550775 Enrollment ID: I20181109000473 |
| Provider Name | Danielle R Hollenbeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659855310 PECOS PAC ID: 3577805746 Enrollment ID: I20190509000051 |
| Provider Name | Jeanetta Carol Conway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760953533 PECOS PAC ID: 6800139775 Enrollment ID: I20190515003315 |
| Provider Name | Chastity R Frederick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780244970 PECOS PAC ID: 9931437159 Enrollment ID: I20190827001284 |
| Provider Name | Michelle E Anesu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740682483 PECOS PAC ID: 5890012587 Enrollment ID: I20200218000604 |
| Provider Name | Carmen Elise Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669896320 PECOS PAC ID: 2961819693 Enrollment ID: I20210325000900 |
| Provider Name | Christa Shea Herring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174118962 PECOS PAC ID: 8820406978 Enrollment ID: I20210409001410 |
| Provider Name | Heather A Pickett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194490185 PECOS PAC ID: 8729483029 Enrollment ID: I20210825001525 |
| Provider Name | Leigha Marie Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003564717 PECOS PAC ID: 2062809817 Enrollment ID: I20220425001949 |
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