Hancock Physician Network, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HANCOCK PHYSICIAN NETWORK, LLC

Practice address

156 W Muskegon Dr
Greenfield, IN 46140-3069

Phone

(317) 468-6260

Fax

(317) 468-6267

NPI assigned

Jul 4, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian Muckerheide

Title

Controller

Phone

(317) 468-6236

Specialties & licenses 14

Addresses

Other identifiers 13

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Hancock Regional Hospital

  dba Wellbrooke of South Bend

  • Skilled Nursing Facility
  • South Bend, IN
  • NPI 1821427857

  Member Of

  NPD member
• St. Vincent Hospital and Health Care Center, Inc.

  dba St. Vincent Pediatric Subspecialties

  • Neonatal-Perinatal Medicine Physician
  • Fort Wayne, IN
  • NPI 1023203239

  Member Of

  NPD member

Locations

Practitioners 267

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rona A. Abu Manneh, M.D.

  • Internal Medicine Physician
  • Fishers, IN
  • NPI 1548432511

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Sewit Amde, M.D.

  • Plastic Surgery Physician
  • Greenfield, IN
  • NPI 1558597807
  Medicare reassignment Care Compare group NPD
• Margaret Rose Andonian

  • Family Nurse Practitioner
  • Greenfield, IN
  • NPI 1679296859

  Registered Nurse

  Medicare reassignment Care Compare group NPD
• Kara Jean Armstrong, NP

  • Family Nurse Practitioner
  • Bainbridge, IN
  • NPI 1902384274
  Medicare reassignment Care Compare group NPD
• Jay Badell, DPM

  • Foot & Ankle Surgery Podiatrist
  • Greenfield, IN
  • NPI 1679035034
  Medicare reassignment Care Compare group NPD
• Kristin S Bagley, M.D.

  • Family Medicine Physician
  • New Palestine, IN
  • NPI 1710971734
  Medicare reassignment Care Compare group NPD
• Mirza M Baig, M.D, FACP

  • Nephrology Physician
  • Greenfield, IN
  • NPI 1134371487

  Hospitalist

  Medicare reassignment Care Compare group NPD
• Nalini A Bangalore, MD

  • Internal Medicine Physician
  • McCordsville, IN
  • NPI 1669413043
  Medicare reassignment Care Compare group NPD
• Amanda B Bazan, FNP

  • Family Nurse Practitioner
  • New Castle, IN
  • NPI 1205334448
  Medicare reassignment Care Compare group NPD
• Robert Beyerlein, CRNA

  • Certified Registered Nurse Anesthetist
  • Indianapolis, IN
  • NPI 1003273582
  Medicare reassignment Care Compare group NPD
• Elizabeth A Blachly, M.D.

  • Family Medicine Physician
  • New Palestine, IN
  • NPI 1740282201
  Medicare reassignment Care Compare group NPD
• Markian R Bochan, MD

  • Infectious Disease Physician
  • Carmel, IN
  • NPI 1972541936
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1609806470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 129",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461400129",
            "telephone_number": "317-468-6270",
            "fax_number": "317-468-6268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 W MUSKEGON DR",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461403069",
            "telephone_number": "317-468-6260",
            "fax_number": "317-468-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANCOCK PHYSICIAN NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MUCKERHEIDE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "317-468-6236"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IN",
            "license": "70000074A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28075482A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IN",
            "license": "01061823A",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01062448A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01064501A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01052168A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200841490",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "01062448A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI  NUMBER",
            "identifier": "1982757373",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI  NUMBER",
            "identifier": "1467485003",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN NUMBER",
            "identifier": "000000493483",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200311740",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITALIST",
            "identifier": "208M00000X",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NIMBER",
            "identifier": "1548272289",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200853260",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "01061823A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSR NUMBER",
            "identifier": "01061823B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI  NUMBER",
            "identifier": "111401698",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200311740D",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hancock Health Gateway Services Inc (Gateway Imaging)
• Hancock Health Gateway Services, Inc. (Gateway Immediate Care)
• Hancock Health Gateway Services, Inc. (Gateway Lab)
• Hancock OB Anesthesia
• Hancock OB-GYN P.C.
• Hancock Regional Hospital
• Hancock Regional Hospital (Hancock Regional Hospital IRU)
• Hancock Regional Hospital
• Hancock Regional Hospital (Hancock Well-Being at Work-Gateway)
• Hancock Regional Hospital (Hancock Well Being at Work-Greenfield)

• Family Medicine Physician in Greenfield, IN
• Providers in Greenfield, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.