| Knox Winamac Community Health Centers Inc | |
|
1002 S Edgewood Dr Knox IN 46534-8226 | |
| (574) 772-6030 | |
| (574) 772-7494 |
| Full Name | Knox Winamac Community Health Centers Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1002 S Edgewood Dr, Knox, Indiana |
| Authorized Official Name and Position | Kathy Robb (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5747726030 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Knox Winamac Community Health Centers Inc 1002 S Edgewood Dr Knox IN 46534-8226 Ph: (574) 772-6030 | Knox Winamac Community Health Centers Inc 1002 S Edgewood Dr Knox IN 46534-8226 Ph: (574) 772-6030 |
| NPI Number | 1629248919 |
|---|---|
| Provider Enumeration Date | 03/03/2008 |
| Last Update Date | 10/07/2016 |
| Medicare PECOS PAC ID | 9537229802 |
|---|---|
| Medicare Enrollment ID | O20100113000557 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629248919 | NPI | - | NPPES |
| 200897290A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Indiana) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Alexander C Gatzimos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548476120 PECOS PAC ID: 3870565773 Enrollment ID: I20040811000363 |
| Provider Name | John W Bulger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821123035 PECOS PAC ID: 9032150446 Enrollment ID: I20050517000851 |
| Provider Name | Lori A Truesdell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730120148 PECOS PAC ID: 2668502576 Enrollment ID: I20100618000535 |
| Provider Name | Walter Elmer Fritz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851330112 PECOS PAC ID: 7012068257 Enrollment ID: I20100902000209 |
| Provider Name | Renae C Atkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700122579 PECOS PAC ID: 7911144456 Enrollment ID: I20130501000029 |
| Provider Name | Kim Mccullough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174970487 PECOS PAC ID: 1153613500 Enrollment ID: I20160706000855 |
| Provider Name | David Edward Cook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538272133 PECOS PAC ID: 7214031392 Enrollment ID: I20200113000499 |
| Provider Name | Roger Wayne Farris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902491558 PECOS PAC ID: 6709293178 Enrollment ID: I20210331001716 |
| Provider Name | Beverly R Kaunda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376124578 PECOS PAC ID: 2264831809 Enrollment ID: I20210601002217 |
| Provider Name | Lesley Amber Metts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205509726 PECOS PAC ID: 6608273198 Enrollment ID: I20210927001348 |
A.n. Damodaran, M.d. Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 S Pearl St, Knox, IN 46534 Phone: 574-207-5050 Fax: 574-207-5002 | |
Knox Family Practice Rhc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1520 S Heaton St, Knox, IN 46534 Phone: 574-772-2188 Fax: 574-772-2190 | |
Center For Family Health Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1006 S Edgewood Dr, Knox, IN 46534 Phone: 574-772-5505 Fax: 574-772-6151 | |
Laporte Regional Physician Network, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 S Heaton, Knox, IN 46534 Phone: 574-772-3187 Fax: 574-772-4843 | |
Robert R Cornwell Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 S Heaton St, Knox, IN 46534 Phone: 574-772-7300 Fax: 574-772-7301 | |
Pulaski Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2 S Pearl St, Knox, IN 46534 Phone: 574-207-5050 | |
Knox Winamac Community Health Centers, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1002 S Edgewood Dr, Knox, IN 46534 Phone: 574-772-6030 Fax: 574-772-7494 |