Douglas John Ladika, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10000987A Issued in IN

Practice address

151 E Bow St
Thorntown, IN 46071

Phone

(765) 436-2400

Fax

(765) 436-7375

NPI assigned

Sep 19, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Doug Ladika Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Health and Wellness of Carmel, LLC

  • Family Medicine Physician
  • Carmel, IN
  • NPI 1477786853
  Medicare reassignment
• Central PA Emergency Physicians

  • Emergency Medicine Physician
  • Williamsport, PA
  • NPI 1295786622
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1104076769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 N LEBANON ST STE 305",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460528622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 E BOW ST",
            "city": "THORNTOWN",
            "state": "IN",
            "postal_code": "46071",
            "telephone_number": "765-436-2400",
            "fax_number": "765-436-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADIKA",
        "first_name": "DOUGLAS",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-19",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10000987A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300004507",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "douglas.ladika@whs.eclinicaldirectplus.com",
            "affiliation": "Y",
            "affiliationName": "Witham Memorial Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "151 E Bow St",
            "city": "Thorntown",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DOUG",
            "last_name": "LADIKA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Holly L Hopkins, RN, CNM
• Joseph William Keck, DDS
• Megan Bartlett Keck, DDS
• Lindsay C. Ketzner, MD
• Gretchen Elizabeth Knight, RN
• Cathy A Maners
• Garrett Houston Markham
• Randel Pharmacy
• John Dee Randel, PHARMACIST
• Alena Marci Sentir, LMHC, ATR-BC

• Medical Physician Assistant in Thorntown, IN
• Providers in Thorntown, IN by specialty
• Medical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.