Apollo Medical Group of Jeffersonville LLC
Organization Active NPI Anesthesiology Physician · Jeffersonville, IN
NPI 1124607205 · NPPES record last updated Apr 5, 2023
Key facts
- NPI
- 1124607205
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- APOLLO MEDICAL GROUP OF JEFFERSONVILLE LLC
- Practice address
- 2990 Gottbrath Pkwy
Jeffersonville, IN 47130-8901 - Phone
- (812) 671-0990
- NPI assigned
- Apr 6, 2021
- Organization subpart
- No
Authorized official
- Name
- Robin Van Sprundel
- Title
- Director of Administration
- Phone
- (941) 725-1198
Practitioners 52
-
Ayman Elfar, MD
-
Jason W Caldwell, CRNA
-
Christopher Cotton, MSN, CRNA
-
Jennifer Lee Frederick, CRNA
-
Jason Samuel Garrison, M.D.
-
Sarah Loiacano, CRNA
-
Cynthia L. Northcutt, CRNA
-
Justin A Otis, DNP, APRN-CRNA
-
Carey M. Pilo, D.O.
-
Mirabelle Reyes, D.O.
-
Jason Paul Sanders, APRN-NA
-
Sarah Michelle Sanders, CRNA
-
Dana Marie Settles, M.D.
-
Kimberly Jean Bibb, CRNA
-
Thomas Habimana, CRNA
-
Kyle Bryce Coker, C.R.N.A
-
Tiffany Farrell, CRNA
-
Jeremy Allen Haysley, M.D.
-
Sayed Eyedn Khosrowshahi, CRNA
-
Michael Dale Lance II, CRNA
-
Timothy D Ward, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210521000410 | IN | Part B Supplier - Clinic/Group Practice | 8729487897 |
Receives reassigned benefits from 52 practitioners Practice locations: Jeffersonville, IN |
National Provider Directory
Locations
400 Corporate Dr
Ste 100
Jeffersonville, IN 47130
Phone (502) 693-5292
2990 Gottbrath Pkwy
Jeffersonvlle, IN 47130
Phone (812) 670-0990
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes | ||
| Certified Registered Nurse Anesthetist |
367500000X |
Addresses
Primary practice location
2990 Gottbrath Pkwy
Jeffersonville, IN 47130-8901
Mailing address
PO Box 3903
Springfield, IL 62708-3903
Phone (941) 360-1566
Other providers in Jeffersonville, IN
- Anew Holistic LLC
- Rachael Anglin
- Antidote Recovery LLC
- Dawn Renee Antle
- Edwin James Apenbrinck
- Whitney Arbuckle
- Arlene Kraut MD OB-GYN LLC
- Kristin Armstrong
- Haley Arnett
- Alan Hilt Arnold
All providers in Jeffersonville, IN · Anesthesiology Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.