| Hpw Center For Diabetes, Llc | |
|
3560 S 4th St Terre Haute IN 47802-5540 | |
| (812) 235-8496 | |
| (812) 478-1540 |
| Full Name | Hpw Center For Diabetes, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3560 S 4th St, Terre Haute, Indiana |
| Authorized Official Name and Position | Isaiah Pittman (OWNER) |
| Authorized Official Contact | 8122358496 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hpw Center For Diabetes, Llc 3560 S 4th St Terre Haute IN 47802-5540 Ph: (812) 235-8496 | Hpw Center For Diabetes, Llc 3560 S 4th St Terre Haute IN 47802-5540 Ph: (812) 235-8496 |
| NPI Number | 1043680515 |
|---|---|
| Provider Enumeration Date | 09/28/2015 |
| Last Update Date | 08/25/2023 |
| Medicare PECOS PAC ID | 9537568993 |
|---|---|
| Medicare Enrollment ID | O20210604001734 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043680515 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 01058414 (Indiana) | Primary |
| Provider Name | Isaiah Pittman |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1588638928 PECOS PAC ID: 5597724641 Enrollment ID: I20041005001096 |
| Provider Name | Tiffany Terhune |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851838320 PECOS PAC ID: 5597036921 Enrollment ID: I20170803002038 |
| Provider Name | Tamara Gorman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154953099 PECOS PAC ID: 4082041025 Enrollment ID: I20200303002246 |
| Provider Name | Brandi Rhoads |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396320461 PECOS PAC ID: 1658760806 Enrollment ID: I20220224001477 |
| Provider Name | Braxton Reed Shidler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013660786 PECOS PAC ID: 4385038686 Enrollment ID: I20220302002975 |
| Provider Name | Carrie Ann Deakins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013635333 PECOS PAC ID: 0941686018 Enrollment ID: I20220928000545 |
| Provider Name | Andrea Lynn Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053032482 PECOS PAC ID: 2668849043 Enrollment ID: I20230316002487 |
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