| Meridian Health & Wellness | |
|
8902 N Meridian St 101 Indianapolis IN 46260-5382 | |
| (317) 848-8048 | |
| (317) 575-8807 |
| Full Name | Meridian Health & Wellness |
|---|---|
| Speciality | General Practice |
| Location | 8902 N Meridian St, Indianapolis, Indiana |
| Authorized Official Name and Position | Robert Charles Prahter (PRESIDENT) |
| Authorized Official Contact | 3178488048 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meridian Health & Wellness 8902 N Meridian St 101 Indianapolis IN 46260-5382 Ph: (317) 848-8048 | Meridian Health & Wellness 8902 N Meridian St 101 Indianapolis IN 46260-5382 Ph: (317) 848-8048 |
| NPI Number | 1457608705 |
|---|---|
| Provider Enumeration Date | 08/06/2012 |
| Last Update Date | 08/06/2012 |
| Medicare PECOS PAC ID | 6800047424 |
|---|---|
| Medicare Enrollment ID | O20121108000045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457608705 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | 01025462A (Indiana) | Primary |
| Provider Name | Bala C Rangaswami |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659312759 PECOS PAC ID: 6305743642 Enrollment ID: I20031216000175 |
| Provider Name | Brian Paul Hagedorn |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992855894 PECOS PAC ID: 2769584481 Enrollment ID: I20070227000706 |
| Provider Name | Mark P Rollins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598746240 PECOS PAC ID: 7618076217 Enrollment ID: I20070703000641 |
| Provider Name | Michael T Olson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1033363874 PECOS PAC ID: 1052471745 Enrollment ID: I20081126000076 |
| Provider Name | Patricia Heffner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902283906 PECOS PAC ID: 0749197465 Enrollment ID: I20150625001110 |
| Provider Name | Melissa Hilterman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891156246 PECOS PAC ID: 6406134477 Enrollment ID: I20161026000101 |
| Provider Name | Debi Fehrman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982146080 PECOS PAC ID: 1052687431 Enrollment ID: I20171031000293 |
| Provider Name | Estelle M Daniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861903114 PECOS PAC ID: 7416214317 Enrollment ID: I20171201000504 |
| Provider Name | Courtney Boswell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730650581 PECOS PAC ID: 9335485556 Enrollment ID: I20190109001782 |
| Provider Name | Stephanie N Preston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447882840 PECOS PAC ID: 1052741295 Enrollment ID: I20200430001839 |
| Provider Name | Meghan Nicole Walton |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346835444 PECOS PAC ID: 5294142485 Enrollment ID: I20210406002042 |
| Provider Name | Penny Lane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750576518 PECOS PAC ID: 0749698520 Enrollment ID: I20210415001235 |
| Provider Name | Daniel Wagoner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952070799 PECOS PAC ID: 8426454745 Enrollment ID: I20210910001587 |
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