| Therapy Associates Inc | |
|
700 N Burkhardt Rd Evansville IN 47715-2740 | |
| (812) 474-1110 | |
| (812) 474-1303 |
| Full Name | Therapy Associates Inc |
|---|---|
| Speciality | Radiology |
| Location | 700 N Burkhardt Rd, Evansville, Indiana |
| Authorized Official Name and Position | Jon D. Frazier (OWNER) |
| Authorized Official Contact | 8124741110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapy Associates Inc Po Box 2368 Indianapolis IN 46206-2368 Ph: (800) 331-9294 | Therapy Associates Inc 700 N Burkhardt Rd Evansville IN 47715-2740 Ph: (812) 474-1110 |
| NPI Number | 1205885316 |
|---|---|
| Provider Enumeration Date | 05/08/2006 |
| Last Update Date | 02/21/2012 |
| Medicare PECOS PAC ID | 1951386275 |
|---|---|
| Medicare Enrollment ID | O20040621001973 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205885316 | NPI | - | NPPES |
| 200875500A | Medicaid | IN | |
| 200875500D | Medicaid | IN | |
| 78902871 | Medicaid | KY | |
| 100248410 | Medicaid | IN | |
| 200875500E | Medicaid | IN | |
| 65903858 | Medicaid | KY | |
| CA0132 | Other | IN | RR MEDICARE |
| 200875500C | Medicaid | IN | |
| 200875500B | Medicaid | IN | |
| DO1292 | Other | KY | RR MEDICARE |
| Provider Name | Jon Durwood Frazier |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1679572507 PECOS PAC ID: 3476548439 Enrollment ID: I20061110000276 |
| Provider Name | Shannon S Lamb |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1891758272 PECOS PAC ID: 2062424989 Enrollment ID: I20061229000228 |
| Provider Name | Noah A Taylor |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1962497107 PECOS PAC ID: 7113015488 Enrollment ID: I20120120000506 |
| Provider Name | Linda Ann Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467986844 PECOS PAC ID: 6002183621 Enrollment ID: I20170601001226 |
| Provider Name | Mariah L Atkinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285109413 PECOS PAC ID: 3072859461 Enrollment ID: I20190104002731 |
| Provider Name | Caroline Coughlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184243289 PECOS PAC ID: 2264862424 Enrollment ID: I20200501000114 |
| Provider Name | Jesse Lynn Kuhlenschmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629640123 PECOS PAC ID: 2961894159 Enrollment ID: I20220120001600 |
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