| Saint Joseph Health Center | |
|
1919 Lake Ave Ste 102b Plymouth IN 46563-7830 | |
| (574) 335-6800 | |
| (574) 948-5480 |
| Full Name | Saint Joseph Health Center |
|---|---|
| Speciality | Family Medicine |
| Location | 1919 Lake Ave Ste 102b, Plymouth, Indiana |
| Authorized Official Name and Position | Christopher James Karam (PRESIDENT) |
| Authorized Official Contact | 5743352344 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Saint Joseph Health Center 5215 Holy Cross Parkway Saint Joseph Provider Services Mishawaka IN 46545-1469 Ph: (574) 335-8707 | Saint Joseph Health Center 1919 Lake Ave Ste 102b Plymouth IN 46563-7830 Ph: (574) 335-6800 |
| NPI Number | 1538585187 |
|---|---|
| Provider Enumeration Date | 03/06/2014 |
| Last Update Date | 10/15/2024 |
| Medicare PECOS PAC ID | 9537071337 |
|---|---|
| Medicare Enrollment ID | O20031223000588 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538585187 | NPI | - | NPPES |
| 000000875287 | Other | IN | BCBS |
| 300036720 | Medicaid | IN | |
| 201216910A | Medicaid | IN |
| Provider Name | Paul J Guentert |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1255316782 PECOS PAC ID: 7012821994 Enrollment ID: I20031117000097 |
| Provider Name | Douglas S Kuehn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730132051 PECOS PAC ID: 6709790256 Enrollment ID: I20040225000104 |
| Provider Name | Timothy S Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952357287 PECOS PAC ID: 7214841766 Enrollment ID: I20040312000359 |
| Provider Name | Steven T Gerstler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174579502 PECOS PAC ID: 5092788414 Enrollment ID: I20040814000122 |
| Provider Name | Michelle L Pearson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841234739 PECOS PAC ID: 3375517477 Enrollment ID: I20040824000968 |
| Provider Name | Edward L Yang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477509156 PECOS PAC ID: 0143295311 Enrollment ID: I20040831000991 |
| Provider Name | Frank V Murphy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881696383 PECOS PAC ID: 5294702163 Enrollment ID: I20040911000189 |
| Provider Name | Julie M Ortega Schmitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861418394 PECOS PAC ID: 1658340542 Enrollment ID: I20040928000484 |
| Provider Name | Sachin R Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770587321 PECOS PAC ID: 2961471503 Enrollment ID: I20041002000126 |
| Provider Name | Ajazuddin Z Shaikh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225032626 PECOS PAC ID: 9234020801 Enrollment ID: I20041002000133 |
| Provider Name | Jason J Ransom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609846062 PECOS PAC ID: 7315904042 Enrollment ID: I20041214001217 |
| Provider Name | Richard L Dobben |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447252184 PECOS PAC ID: 5395631980 Enrollment ID: I20041215000465 |
| Provider Name | Vu Nguyen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073569729 PECOS PAC ID: 4082695770 Enrollment ID: I20050126000143 |
| Provider Name | Rod S Kubley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821037532 PECOS PAC ID: 4486691714 Enrollment ID: I20050408000399 |
| Provider Name | Craig B Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376571265 PECOS PAC ID: 6305883299 Enrollment ID: I20050412001164 |
| Provider Name | Sultan O Niazi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1801874441 PECOS PAC ID: 6709800840 Enrollment ID: I20060117000553 |
| Provider Name | Chester L Rogers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689613382 PECOS PAC ID: 6406870286 Enrollment ID: I20060119000464 |
| Provider Name | John T Taylor |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891891156 PECOS PAC ID: 0840360129 Enrollment ID: I20080529000147 |
| Provider Name | Adam Eric Perlmutter |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1235270067 PECOS PAC ID: 9032205349 Enrollment ID: I20080812000855 |
| Provider Name | Jason R Grove |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1609040088 PECOS PAC ID: 4183791494 Enrollment ID: I20080927000183 |
| Provider Name | Bogdan Sima |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912181017 PECOS PAC ID: 2062574197 Enrollment ID: I20081223000472 |
| Provider Name | Abdul M Malik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952300584 PECOS PAC ID: 7315002979 Enrollment ID: I20090213000292 |
| Provider Name | Janet Galanes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235178856 PECOS PAC ID: 4486708930 Enrollment ID: I20090818000329 |
| Provider Name | Chuck G Nwakanma |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1417984063 PECOS PAC ID: 0840294633 Enrollment ID: I20100105000587 |
| Provider Name | Tod A Stillson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427003573 PECOS PAC ID: 3476604281 Enrollment ID: I20100726000574 |
| Provider Name | Douglas R Liepert |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1083675011 PECOS PAC ID: 1850372541 Enrollment ID: I20100805000286 |
| Provider Name | Mark A Muckway |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265521652 PECOS PAC ID: 6305039454 Enrollment ID: I20101021000106 |
| Provider Name | Zubair Ul Haq |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518005198 PECOS PAC ID: 9133313042 Enrollment ID: I20101104000030 |
| Provider Name | Stephen M Simons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881776359 PECOS PAC ID: 5799974184 Enrollment ID: I20110118000091 |
| Provider Name | Rebecca Brice |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235245002 PECOS PAC ID: 3072510908 Enrollment ID: I20110207000412 |
| Provider Name | Anita L Flohe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497058580 PECOS PAC ID: 9931380235 Enrollment ID: I20110218001021 |
| Provider Name | Linda L Tuthill |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376599522 PECOS PAC ID: 7113831660 Enrollment ID: I20110411000610 |
| Provider Name | Eric Knapp |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700090602 PECOS PAC ID: 7315078490 Enrollment ID: I20110801000723 |
| Provider Name | Leah Napolitano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023116514 PECOS PAC ID: 1658343157 Enrollment ID: I20120110000737 |
| Provider Name | Terrence D Wilkin |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1982656963 PECOS PAC ID: 0941228340 Enrollment ID: I20120216000182 |
| Provider Name | Ryan B Greene |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1518171107 PECOS PAC ID: 2062676778 Enrollment ID: I20120608000486 |
| Provider Name | Jessica G Glassman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992054183 PECOS PAC ID: 9032362280 Enrollment ID: I20130122000030 |
| Provider Name | Kimberley K Mendez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043555394 PECOS PAC ID: 7012161946 Enrollment ID: I20130131000189 |
| Provider Name | Can Talug |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1972708535 PECOS PAC ID: 9830243708 Enrollment ID: I20130225000403 |
| Provider Name | Mohamed O Jahangir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073748422 PECOS PAC ID: 1456526813 Enrollment ID: I20130720000130 |
| Provider Name | Asad Kizilbash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861630907 PECOS PAC ID: 1254485535 Enrollment ID: I20130809000091 |
| Provider Name | Jonathan M Mccrea |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700048923 PECOS PAC ID: 0345499505 Enrollment ID: I20130905000648 |
| Provider Name | Zachary Leshen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285646729 PECOS PAC ID: 8628139367 Enrollment ID: I20130912000734 |
| Provider Name | Pravin Pratap |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1811105810 PECOS PAC ID: 7113181439 Enrollment ID: I20140116001531 |
| Provider Name | Sheraz Younus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396928552 PECOS PAC ID: 1153550116 Enrollment ID: I20140215000111 |
| Provider Name | Laura E Blackford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073892428 PECOS PAC ID: 2567686819 Enrollment ID: I20140917003050 |
| Provider Name | Tabitha M Pollard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891194981 PECOS PAC ID: 0840412805 Enrollment ID: I20141107000871 |
| Provider Name | Christopher C Jordan |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1689938664 PECOS PAC ID: 7012156060 Enrollment ID: I20141231000156 |
| Provider Name | Jennifer P Heaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164814760 PECOS PAC ID: 9931428885 Enrollment ID: I20150428000664 |
| Provider Name | Ziad Y Fayad |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508025867 PECOS PAC ID: 9739321837 Enrollment ID: I20150616001388 |
| Provider Name | Kathryn Zehr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144601808 PECOS PAC ID: 8426366386 Enrollment ID: I20150928000277 |
| Provider Name | Rachel J Pippenger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164893616 PECOS PAC ID: 0042529604 Enrollment ID: I20151021002019 |
| Provider Name | Steve Sikorevich |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1447489125 PECOS PAC ID: 7012158041 Enrollment ID: I20151216001558 |
| Provider Name | Peter Miller |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1295991081 PECOS PAC ID: 1850537697 Enrollment ID: I20160526001186 |
| Provider Name | Justin M Leugers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679922355 PECOS PAC ID: 7113210568 Enrollment ID: I20160722002353 |
| Provider Name | Brian K. Penrose |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1437508116 PECOS PAC ID: 9638463193 Enrollment ID: I20160805000502 |
| Provider Name | Anthony J Witt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083063762 PECOS PAC ID: 0648565788 Enrollment ID: I20160829000436 |
| Provider Name | Anthony R Gauthier |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1548203540 PECOS PAC ID: 1951313212 Enrollment ID: I20170306000945 |
| Provider Name | Dawn L Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629514799 PECOS PAC ID: 0446536619 Enrollment ID: I20170425000649 |
| Provider Name | Aimee Lee Clady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902345879 PECOS PAC ID: 4688951312 Enrollment ID: I20170508000948 |
| Provider Name | Denise Rehfuss |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205017241 PECOS PAC ID: 8820249352 Enrollment ID: I20170817000362 |
| Provider Name | Nabil A Khan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841579406 PECOS PAC ID: 6204059546 Enrollment ID: I20170926001059 |
| Provider Name | Eric James Rindlisbacher |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1689088783 PECOS PAC ID: 5395960587 Enrollment ID: I20170929000585 |
| Provider Name | Abdul Sami Qazi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366508228 PECOS PAC ID: 8022110287 Enrollment ID: I20180112001357 |
| Provider Name | Umair Saleem |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548528029 PECOS PAC ID: 3072896018 Enrollment ID: I20180611000374 |
| Provider Name | Neha Sharma |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1750541892 PECOS PAC ID: 9032365713 Enrollment ID: I20180629000700 |
| Provider Name | Krystal Kay Lavine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821586207 PECOS PAC ID: 2466705181 Enrollment ID: I20181026001342 |
| Provider Name | Qussai Salamah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447554654 PECOS PAC ID: 5294904462 Enrollment ID: I20181220003361 |
| Provider Name | Mahmud Zamlut |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1952579542 PECOS PAC ID: 4688740384 Enrollment ID: I20190109002457 |
| Provider Name | Marla M Troyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114482676 PECOS PAC ID: 8921348285 Enrollment ID: I20190322001523 |
| Provider Name | Laura Satka Gettler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114499654 PECOS PAC ID: 1658612684 Enrollment ID: I20190401001017 |
| Provider Name | Jeremy L Gunter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285198150 PECOS PAC ID: 0547502775 Enrollment ID: I20190508001605 |
| Provider Name | Shishir Ojha |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1225223803 PECOS PAC ID: 3779711213 Enrollment ID: I20190521003085 |
| Provider Name | Donald R Westerhausen |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1437491974 PECOS PAC ID: 4688977515 Enrollment ID: I20190522002386 |
| Provider Name | Daniel Nwankwo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639526007 PECOS PAC ID: 2860735248 Enrollment ID: I20190529000434 |
| Provider Name | Anna N Matulewicz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184966681 PECOS PAC ID: 3072749449 Enrollment ID: I20190611001203 |
| Provider Name | Benjamin Cale Friesen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366905275 PECOS PAC ID: 0840524179 Enrollment ID: I20190620001091 |
| Provider Name | Muhammad M Mufti |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215396148 PECOS PAC ID: 3173851854 Enrollment ID: I20190912000393 |
| Provider Name | Syed M Raza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578737219 PECOS PAC ID: 3577788199 Enrollment ID: I20190918003100 |
| Provider Name | Tarek Saleh |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790915544 PECOS PAC ID: 5597915959 Enrollment ID: I20200422001851 |
| Provider Name | Nicole B Bolinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578195913 PECOS PAC ID: 6103256417 Enrollment ID: I20200428000567 |
| Provider Name | Dana Oberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598387250 PECOS PAC ID: 9335560010 Enrollment ID: I20200604002244 |
| Provider Name | Apeksha R Shah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992324883 PECOS PAC ID: 4880018795 Enrollment ID: I20200724002078 |
| Provider Name | Candie Christine Books |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194334631 PECOS PAC ID: 9436574498 Enrollment ID: I20200807000985 |
| Provider Name | Jeffrey Rosenwinkel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215466222 PECOS PAC ID: 2062782683 Enrollment ID: I20200813000304 |
| Provider Name | Iryna Vitaliyivna Polyakova |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447633326 PECOS PAC ID: 1759638430 Enrollment ID: I20201002000088 |
| Provider Name | Harsha Nagarajarao |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548471311 PECOS PAC ID: 8022235605 Enrollment ID: I20201009000915 |
| Provider Name | Cecilia M Maina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023640117 PECOS PAC ID: 6709206253 Enrollment ID: I20201021003003 |
| Provider Name | Frank Addo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679592828 PECOS PAC ID: 0042215592 Enrollment ID: I20201125001501 |
| Provider Name | Nelson B Isada |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508925611 PECOS PAC ID: 0244394930 Enrollment ID: I20201204002341 |
| Provider Name | Elizabeth W Maina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013505668 PECOS PAC ID: 7315351251 Enrollment ID: I20210204000438 |
| Provider Name | John P Anastos |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780684886 PECOS PAC ID: 5597660175 Enrollment ID: I20210308001642 |
| Provider Name | Randall John Bjork |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265434112 PECOS PAC ID: 3678460912 Enrollment ID: I20210415002028 |
| Provider Name | Truptiben Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275067225 PECOS PAC ID: 9931517257 Enrollment ID: I20210426001184 |
| Provider Name | David Johnson |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1467981464 PECOS PAC ID: 6204105158 Enrollment ID: I20210526001066 |
| Provider Name | Morgan Joann Faanes |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1659860096 PECOS PAC ID: 8123373867 Enrollment ID: I20210623001553 |
| Provider Name | Jordan Frances Geroski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265962633 PECOS PAC ID: 1153690037 Enrollment ID: I20210629002571 |
| Provider Name | Zaid Farooq |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1437504768 PECOS PAC ID: 1456645472 Enrollment ID: I20210716000376 |
| Provider Name | Cara Park |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407430408 PECOS PAC ID: 0042612764 Enrollment ID: I20210716001560 |
| Provider Name | Breanna Marie Kartes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538740121 PECOS PAC ID: 2264835438 Enrollment ID: I20210726001846 |
| Provider Name | Luis F Gomez |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1538570460 PECOS PAC ID: 8820499742 Enrollment ID: I20211029001728 |
| Provider Name | Anitha Rao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396989976 PECOS PAC ID: 5193965713 Enrollment ID: I20211130000666 |
| Provider Name | Jasmine Christine Christopher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013421049 PECOS PAC ID: 3971993239 Enrollment ID: I20211201001641 |
| Provider Name | Anthony Mozer |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1730446915 PECOS PAC ID: 9830498799 Enrollment ID: I20220519000385 |
| Provider Name | Kristin A Sharp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154881993 PECOS PAC ID: 3779817986 Enrollment ID: I20220801002197 |
| Provider Name | Collese Nicole Mckee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730810078 PECOS PAC ID: 1759764483 Enrollment ID: I20220812002898 |
| Provider Name | Shauntel Nichole Marcin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689305948 PECOS PAC ID: 1658754619 Enrollment ID: I20220824001210 |
| Provider Name | Rebecca Anne Romine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861118069 PECOS PAC ID: 4880061357 Enrollment ID: I20221114001354 |
| Provider Name | Kelsey Anna Wagoner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144941758 PECOS PAC ID: 2769851872 Enrollment ID: I20221213000715 |
| Provider Name | Brandy Monique Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225716988 PECOS PAC ID: 2365806247 Enrollment ID: I20230911002741 |
| Provider Name | Ngan Nguyen |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1376994269 PECOS PAC ID: 5496099517 Enrollment ID: I20230918001937 |
| Provider Name | Breanne Nichole Lawrence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609554997 PECOS PAC ID: 9638523970 Enrollment ID: I20230920003569 |
Byron M. Holm, Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2855 Miller Dr, Suite 117, Plymouth, IN 46563 Phone: 574-936-7777 Fax: 574-941-1072 | |
Proactive Md Plymouth Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 504 Colonial Ct, Plymouth, IN 46563 Phone: 812-645-1892 | |
Lifeplex Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2855 Miller Dr Ste 117, Plymouth, IN 46563 Phone: 574-936-7777 Fax: 574-941-1072 | |
Saint Joseph Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2349 Lake Ave Ste 99, Plymouth, IN 46563 Phone: 574-948-5340 Fax: 574-948-5494 | |
Family Medicine Center Of Plymouth Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 105 Water St, Plymouth, IN 46563 Phone: 574-936-3178 Fax: 574-936-1084 | |
Holm Medical Clinic Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2855 Miller Dr Ste 205, Plymouth, IN 46563 Phone: 574-286-0200 |