| Damien Center | |
|
26 N Arsenal Ave Indianapolis IN 46201-3808 | |
| (317) 632-0123 | |
| (317) 632-4362 |
| Full Name | Damien Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 26 N Arsenal Ave, Indianapolis, Indiana |
| Authorized Official Name and Position | Joshua Bundy (DIRECTOR) |
| Authorized Official Contact | 3176320123 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Damien Center 26 N Arsenal Ave Indianapolis IN 46201-3808 Ph: (317) 632-0123 | Damien Center 26 N Arsenal Ave Indianapolis IN 46201-3808 Ph: (317) 632-0123 |
| NPI Number | 1821172248 |
|---|---|
| Provider Enumeration Date | 10/24/2006 |
| Last Update Date | 08/06/2024 |
| Medicare PECOS PAC ID | 1052732666 |
|---|---|
| Medicare Enrollment ID | O20200608002184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821172248 | NPI | - | NPPES |
| 300050482 | Medicaid | IN | |
| 300040883 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Kathryn Eschmann |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871577692 PECOS PAC ID: 1759341464 Enrollment ID: I20041018000313 |
| Provider Name | Gregory Lorenz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437142502 PECOS PAC ID: 8325097199 Enrollment ID: I20050119000467 |
| Provider Name | Julia A Gadlage |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578886875 PECOS PAC ID: 3779613351 Enrollment ID: I20100608000446 |
| Provider Name | Markian R Bochan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1972541936 PECOS PAC ID: 8729110341 Enrollment ID: I20100719000003 |
| Provider Name | Erin O Weah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790703601 PECOS PAC ID: 5698791200 Enrollment ID: I20111228000241 |
| Provider Name | Alexis Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164806436 PECOS PAC ID: 0547574675 Enrollment ID: I20150804003774 |
| Provider Name | Teresa Driskell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023233194 PECOS PAC ID: 0143517979 Enrollment ID: I20160922001042 |
| Provider Name | Juan Carlos Venis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043623069 PECOS PAC ID: 8628295078 Enrollment ID: I20170807003704 |
| Provider Name | Joshua Vanderbur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417424144 PECOS PAC ID: 6507102514 Enrollment ID: I20190111002830 |
| Provider Name | Roslynn Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497280382 PECOS PAC ID: 6608142617 Enrollment ID: I20200513000902 |
| Provider Name | Cassandra L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811537244 PECOS PAC ID: 0749606259 Enrollment ID: I20200814000574 |
| Provider Name | Ross Dorsey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407416233 PECOS PAC ID: 2860810728 Enrollment ID: I20200909002565 |
| Provider Name | Dana L Bernacchi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326567983 PECOS PAC ID: 9537589114 Enrollment ID: I20201020003583 |
| Provider Name | Nadine Y Horn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568092716 PECOS PAC ID: 9739591777 Enrollment ID: I20201215002362 |
| Provider Name | Lane M Sawyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841804655 PECOS PAC ID: 2163828344 Enrollment ID: I20210914001708 |
| Provider Name | Lyndsey Mundell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346966603 PECOS PAC ID: 8921453010 Enrollment ID: I20231010000939 |
| Provider Name | Nicholas Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023569324 PECOS PAC ID: 7911350723 Enrollment ID: I20240129001945 |
| Provider Name | S. Alexander Kemery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114632841 PECOS PAC ID: 7214380740 Enrollment ID: I20240131002143 |
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