| Southway Urgent Center | |
|
1651 E 29th St Muncie IN 47302-5886 | |
| (765) 286-7000 | |
| Not Available |
| Full Name | Southway Urgent Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1651 E 29th St, Muncie, Indiana |
| Authorized Official Name and Position | Toni R Estep (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7652814257 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southway Urgent Center Po Box 1676 Muncie IN 47308-1676 Ph: (765) 281-4257 | Southway Urgent Center 1651 E 29th St Muncie IN 47302-5886 Ph: (765) 286-7000 |
| NPI Number | 1770510240 |
|---|---|
| Provider Enumeration Date | 06/28/2006 |
| Last Update Date | 05/08/2019 |
| Medicare PECOS PAC ID | 5890696603 |
|---|---|
| Medicare Enrollment ID | O20040115000592 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770510240 | NPI | - | NPPES |
| 200167970F | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | William Ma |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396854345 PECOS PAC ID: 3476518382 Enrollment ID: I20041119000656 |
| Provider Name | Elizabeth A Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366495103 PECOS PAC ID: 7315987575 Enrollment ID: I20050506000178 |
| Provider Name | Lisa L Woods |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174575823 PECOS PAC ID: 8820030059 Enrollment ID: I20050526000839 |
| Provider Name | Randy K Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629067202 PECOS PAC ID: 1951337831 Enrollment ID: I20050712000823 |
| Provider Name | Carol L Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861720500 PECOS PAC ID: 4486683570 Enrollment ID: I20050809000675 |
| Provider Name | Vipin Jain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801849112 PECOS PAC ID: 0244234151 Enrollment ID: I20060907000545 |
| Provider Name | Max H Rudicel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770582785 PECOS PAC ID: 7810800471 Enrollment ID: I20071130000055 |
| Provider Name | John C Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508880642 PECOS PAC ID: 0547322422 Enrollment ID: I20081231000379 |
| Provider Name | Alan Maugherman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336219039 PECOS PAC ID: 9234292756 Enrollment ID: I20090109000503 |
| Provider Name | Miriam L Ibrahim |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1194768549 PECOS PAC ID: 8123916442 Enrollment ID: I20100608000118 |
| Provider Name | Kristin Perrone-mcgovern |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083759336 PECOS PAC ID: 9830361740 Enrollment ID: I20111018000473 |
| Provider Name | Jason C Sims |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1639188493 PECOS PAC ID: 6800051566 Enrollment ID: I20120702000034 |
| Provider Name | Erika A Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376979245 PECOS PAC ID: 6608004221 Enrollment ID: I20140106000347 |
| Provider Name | Brandy M Lopilato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952778052 PECOS PAC ID: 1456669514 Enrollment ID: I20151009000948 |
| Provider Name | Ashley M Keim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740639186 PECOS PAC ID: 5698060499 Enrollment ID: I20160818000056 |
| Provider Name | Yousuf A Bahrami |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548641525 PECOS PAC ID: 8224341359 Enrollment ID: I20170119002368 |
| Provider Name | Shannon L Craig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114443405 PECOS PAC ID: 7719251651 Enrollment ID: I20170915002866 |
| Provider Name | Erin Michelle Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073032207 PECOS PAC ID: 1254697899 Enrollment ID: I20171114002580 |
| Provider Name | Shereene A Grant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033505375 PECOS PAC ID: 8022389485 Enrollment ID: I20180723000358 |
| Provider Name | Shelly Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770060360 PECOS PAC ID: 0547518698 Enrollment ID: I20180806001382 |
| Provider Name | Kathryn Joann Campbell Feeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508355173 PECOS PAC ID: 0042562027 Enrollment ID: I20181003001656 |
| Provider Name | Vishal Viswam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245670611 PECOS PAC ID: 8123320595 Enrollment ID: I20181207002201 |
| Provider Name | Kristin Lee Grant |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497909634 PECOS PAC ID: 9234313768 Enrollment ID: I20190822000938 |
| Provider Name | Beena M Joseph |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164676979 PECOS PAC ID: 0345391256 Enrollment ID: I20190912002140 |
| Provider Name | Deanna Elleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972154078 PECOS PAC ID: 9830420967 Enrollment ID: I20191003002630 |
| Provider Name | Heather Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518508142 PECOS PAC ID: 3274965637 Enrollment ID: I20191123000131 |
| Provider Name | Veronica Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750850558 PECOS PAC ID: 5395178792 Enrollment ID: I20191125001850 |
| Provider Name | Afshan Jabeen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780992313 PECOS PAC ID: 1557798121 Enrollment ID: I20200219002929 |
| Provider Name | Catherine B Baugher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124653803 PECOS PAC ID: 4082043492 Enrollment ID: I20200407000842 |
| Provider Name | Abigail L Falloon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902490675 PECOS PAC ID: 8426465188 Enrollment ID: I20210324001353 |
| Provider Name | Jessica Ann Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740953959 PECOS PAC ID: 8628474657 Enrollment ID: I20210831000838 |
| Provider Name | Nicholas A Lee |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124215777 PECOS PAC ID: 2668870270 Enrollment ID: I20211013000319 |
| Provider Name | Katlyn D Corpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275106288 PECOS PAC ID: 9739579988 Enrollment ID: I20211202002634 |
| Provider Name | Corie Hess |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467927053 PECOS PAC ID: 8820485337 Enrollment ID: I20220503000419 |
| Provider Name | Erin L Tingler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649901216 PECOS PAC ID: 1456733567 Enrollment ID: I20220806000264 |
| Provider Name | Hannah M Huff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972166106 PECOS PAC ID: 0042693939 Enrollment ID: I20220809004027 |
| Provider Name | Carrie F Bonsack |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1164477188 PECOS PAC ID: 0345547972 Enrollment ID: I20230317002478 |
| Provider Name | Erick Hernandez |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1972221083 PECOS PAC ID: 8628435286 Enrollment ID: I20230613002123 |
| Provider Name | Teresa Grizzle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285400341 PECOS PAC ID: 3678926490 Enrollment ID: I20240129002181 |
| Provider Name | Katherine Mack |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124676184 PECOS PAC ID: 4183077902 Enrollment ID: I20240129002322 |
| Provider Name | Sheryl Maupin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023655263 PECOS PAC ID: 2264885904 Enrollment ID: I20240129003279 |
| Provider Name | Megan Boruff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215570502 PECOS PAC ID: 8820441538 Enrollment ID: I20240130001066 |
| Provider Name | Mary Reinhard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740549815 PECOS PAC ID: 9436502085 Enrollment ID: I20240130002944 |
| Provider Name | Kenrick N Kwoczalla |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932349677 PECOS PAC ID: 0840690772 Enrollment ID: I20240206002245 |
| Provider Name | Brigina B Mckay |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093951048 PECOS PAC ID: 0446651806 Enrollment ID: I20240207001630 |
| Provider Name | Cory Matters |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568159184 PECOS PAC ID: 3476996257 Enrollment ID: I20240208002160 |
| Provider Name | Victoria Foerster |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548862253 PECOS PAC ID: 9436594439 Enrollment ID: I20240229002470 |
Iu Health Workpalce Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3700 W Kilgore Ave, Muncie, IN 47304 Phone: 765-289-5437 | |
Meridian Health Services Corp. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 N Walnut St # 1, Muncie, IN 47305 Phone: 765-288-1928 | |
Open Door Health Services Behavioral Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1804-1806 West Royale Dr, Muncie, IN 47304 Phone: 765-286-7000 | |
Meridian Health Services Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2501 W Jackson St, Muncie, IN 47303 Phone: 765-288-1928 Fax: 765-741-0362 | |
Iu Health Workplace Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 N Tillotson Ave, Muncie, IN 47304 Phone: 765-747-3888 | |
Open Door Health Services, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2600 W White River Blvd, Muncie, IN 47303 Phone: 765-286-7000 | |
Iu Health Ball Memorial Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 215 S Hutchinson Ave, Muncie, IN 47303 Phone: 765-281-6920 Fax: 765-284-6151 |