| Mr Kenneth Francis Raderstorf Iii, NP | |
| 
					3301 County Road 6 E, Elkhart, IN 46514-7673  | |
| (574) 266-5342 | |
| (574) 266-5847 | 
| Full Name | Mr Kenneth Francis Raderstorf Iii | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Practitioner - Family | 
| Location | 3301 County Road 6 E, Elkhart, Indiana | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1023682416 | NPI | - | NPPES | 
| 300065926 | Medicaid | IN | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 28222082A (Indiana) | Primary | 
| Entity Name | Beacon Medical Group Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1033161617 PECOS PAC ID: 1254243306 Enrollment ID: O20031105000657  | 
| Entity Name | Elite Emergency Physicians Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1932155371 PECOS PAC ID: 8022087642 Enrollment ID: O20040930000456  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mr Kenneth Francis Raderstorf Iii, NP 3245 Health Dr Ste 100, Granger, IN 46530-1380 Ph: (547) 647-2129  | Mr Kenneth Francis Raderstorf Iii, NP 3301 County Road 6 E, Elkhart, IN 46514-7673 Ph: (574) 266-5342  | 
Elizabeth W Maina, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-293-0052  | |
Ms. Cecilia Mumbi Maina, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-293-0052  | |
Rosemary J Eash, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1627 E Bristol St, Elkhart, IN 46514 Phone: 574-262-0313 Fax: 574-262-8163  | |
Lorraine Doris Swartzentruber, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-293-0052  | |
Ashley Marie Brunt, NURSE PRA Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 600 East Blvd, Elkhart, IN 46514 Phone: 574-524-7102 Fax: 574-389-4859  | |
Mrs. Catherine E Dos Santos, MSN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3421 S Main St, Elkhart, IN 46517 Phone: 574-295-7178 Fax: 574-295-8822  |