Healthcare Provider Details

I. General information

NPI: 1104178045
Provider Name (Legal Business Name): CAITLIN MARIE TRIERWEILER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAITLIN M. REGER

II. Dates (important events)

Enumeration Date: 10/02/2012
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8244 E US HIGHWAY 36 STE 1260
AVON IN
46123-9613
US

IV. Provider business mailing address

1000 E MAIN ST ATTN MED STAFF OFFICE
DANVILLE IN
46122-1948
US

V. Phone/Fax

Practice location:
  • Phone: 317-838-9355
  • Fax: 317-544-6139
Mailing address:
  • Phone: 317-837-5566
  • Fax: 317-718-6793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10001435A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0004008
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: