| Bloomington Meadows Gp | |
|
3600 N Prow Rd Bloomington IN 47404-1616 | |
| (812) 331-8000 | |
| (812) 331-8985 |
| Full Name | Bloomington Meadows Gp |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 3600 N Prow Rd, Bloomington, Indiana |
| Authorized Official Name and Position | Steve Filton (SR VP CFO) |
| Authorized Official Contact | 6107683300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloomington Meadows Gp 3600 N Prow Rd Bloomington IN 47404-1616 Ph: (812) 331-8000 | Bloomington Meadows Gp 3600 N Prow Rd Bloomington IN 47404-1616 Ph: (812) 331-8000 |
| NPI Number | 1033298120 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 04/13/2015 |
| Medicare PECOS PAC ID | 6002707494 |
|---|---|
| Medicare Enrollment ID | O20040324000255 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033298120 | NPI | - | NPPES |
| 060128000 | Other | IN | MAGELLAN |
| 107936 | Other | IN | ANTHEM |
| 200075480 | Medicaid | IN | |
| 2398043 | Other | OH | OHIO MEDICAID |
| Provider Name | Arthur Lyakhovetsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124097142 PECOS PAC ID: 7113932351 Enrollment ID: I20060209000399 |
| Provider Name | Jennifer A Comer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669513784 PECOS PAC ID: 4486794393 Enrollment ID: I20091224000051 |
| Provider Name | Joel H Griffith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194747618 PECOS PAC ID: 5890976096 Enrollment ID: I20110222000167 |
| Provider Name | Grace Thomas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104860782 PECOS PAC ID: 6608048905 Enrollment ID: I20131120000265 |
| Provider Name | Cyrus D Solhkhah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174710347 PECOS PAC ID: 0547249088 Enrollment ID: I20140114000743 |
| Provider Name | Valerie N Markley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427441583 PECOS PAC ID: 6002134129 Enrollment ID: I20150421001032 |
| Provider Name | Morgan Amelia Mccormick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487067286 PECOS PAC ID: 6901023944 Enrollment ID: I20151013000109 |
| Provider Name | Linda Omalley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780748913 PECOS PAC ID: 5698078426 Enrollment ID: I20160128000118 |
| Provider Name | Charles Y Jin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801966924 PECOS PAC ID: 1658329693 Enrollment ID: I20170331000484 |
| Provider Name | Benjamin Strange Cooley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508245770 PECOS PAC ID: 5395066401 Enrollment ID: I20170727002877 |
| Provider Name | Hillary L Davis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073961918 PECOS PAC ID: 1456642628 Enrollment ID: I20180824000951 |
| Provider Name | Michelle C Mercier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134601552 PECOS PAC ID: 5294086385 Enrollment ID: I20181001000087 |
| Provider Name | Hui Shi Serena Loh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396215786 PECOS PAC ID: 2365789419 Enrollment ID: I20190128000813 |
| Provider Name | Kevin N. Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710479753 PECOS PAC ID: 8426395336 Enrollment ID: I20190131000872 |
| Provider Name | Patrick R Mcguire |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932638988 PECOS PAC ID: 7911275532 Enrollment ID: I20190315000779 |
| Provider Name | Eric Lyakhovetsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134780851 PECOS PAC ID: 4082944392 Enrollment ID: I20191001000285 |
| Provider Name | Peter G Karalis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730686106 PECOS PAC ID: 6406101146 Enrollment ID: I20200518002996 |
| Provider Name | Christine Hopp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942739990 PECOS PAC ID: 3870861404 Enrollment ID: I20200518003060 |
| Provider Name | Shilpa Puri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013446061 PECOS PAC ID: 3476821091 Enrollment ID: I20200518003117 |
| Provider Name | Andrea Marie Patterson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336768191 PECOS PAC ID: 8820419146 Enrollment ID: I20210820000683 |
| Provider Name | Sonja Marie Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053931048 PECOS PAC ID: 1052733821 Enrollment ID: I20210915000274 |
| Provider Name | Molly Renee Shankles Bullington |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346702313 PECOS PAC ID: 7810221843 Enrollment ID: I20211007000474 |
| Provider Name | Kierra Y Hayes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851825814 PECOS PAC ID: 7911231386 Enrollment ID: I20211027000362 |
| Provider Name | Karri Woodard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447912423 PECOS PAC ID: 1355733593 Enrollment ID: I20220119002248 |
| Provider Name | Joseph M Jackmovich |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992326987 PECOS PAC ID: 9234550690 Enrollment ID: I20220823001516 |
| Provider Name | Kimberly S Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265165229 PECOS PAC ID: 7416332119 Enrollment ID: I20220916000374 |
| Provider Name | Sarah Franklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114650868 PECOS PAC ID: 9931584661 Enrollment ID: I20220916001563 |
| Provider Name | Alyssa Ciera Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598394736 PECOS PAC ID: 2567883309 Enrollment ID: I20220929000628 |
| Provider Name | Marley P Oles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275264814 PECOS PAC ID: 8123404696 Enrollment ID: I20221006001557 |
| Provider Name | Shila Thapa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356062467 PECOS PAC ID: 8325416415 Enrollment ID: I20221121002770 |
| Provider Name | Shanaz Judge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710695937 PECOS PAC ID: 2163892910 Enrollment ID: I20230112000857 |
| Provider Name | Sarah J Fisher |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1487661500 PECOS PAC ID: 8729074117 Enrollment ID: I20230419000754 |
| Provider Name | Eric Carl Swanson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669092771 PECOS PAC ID: 8022430339 Enrollment ID: I20230518000162 |
| Provider Name | Chad R Percifield |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629569140 PECOS PAC ID: 4880941178 Enrollment ID: I20230628000288 |
| Provider Name | Matthew Clardy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962282509 PECOS PAC ID: 3375999865 Enrollment ID: I20231019000580 |
| Provider Name | Rachel Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619650215 PECOS PAC ID: 8426406455 Enrollment ID: I20231130002496 |
| Provider Name | Rachel Stahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982452413 PECOS PAC ID: 8426596438 Enrollment ID: I20240821000947 |
Dr. Katy Kopp Miller, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 W 7th St Ste 108, Bloomington, IN 47404 Phone: 765-425-3412 | |
Diane Menke Pence, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 N College Ave, Ste 613, Bloomington, IN 47404 Phone: 812-333-3440 Fax: 812-333-3444 | |
Hoosier United Therapy Service Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2801 E Plateau Place, Bloomington, IN 47401 Phone: 804-386-9216 Fax: 804-464-1483 | |
Bloomington Behavioral Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3802 E 3rd St, Bloomington, IN 47401 Phone: 812-320-4969 | |
Angela R Marshall Psyd Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2525 W Vernal Pike, Bloomington, IN 47404 Phone: 812-345-5114 Fax: 812-339-0369 | |
New Outlook Counseling Center Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5010 N Stone Mill Rd, Suite B, Bloomington, IN 47408 Phone: 812-929-2193 Fax: 888-789-8394 |