PORTER PHYSICIAN SERVICES LLC (NPI# 1285842963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285842963 |
| Entity Type | Organization |
| Organization Name | PORTER PHYSICIAN SERVICES LLC |
| Practice Address |
650 Dickinson Rd Chesterton IN 46304-3387 |
| Practice Telephone | 2194771013 |
| Practice Fax Number | 2195481410 |
| Mailing Telephone | 2194771013 |
| Mailing Fax Number | 2194771410 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2008-06-27 |
| Authorized Official Name | DEBBIE T BREWER (DIRECTOR OF PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 6154657626 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200865650A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376744664 | Porter Physician Services LLC | Physical Medicine & Rehabilitation | 3220 Lancer St, Portage, IN 46368-4495 | 2007-05-31 |
| 1508075680 | Porter Physician Services LLC | Nurse Practitioner | 650 Dickinson Rd, Suite A, Chesterton, IN 46304-3387 | 2007-05-22 |
| 1457566309 | Porter Physician Services LLC | Family Medicine | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2007-05-14 |
| Street Address |
650 DICKINSON RD |
| City | CHESTERTON |
| State | IN |
| Zip Code | 46304-3387 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043202567 | Theodore Lyons Stern | Emergency Medicine | 650 Dickinson Rd, Chesterton, IN 46304-3387 | 2005-08-19 |
| 1790205292 | Jessica Lynn Wisdom | Nurse Practitioner | 650 Dickinson Rd, Chesterton, IN 46304-3387 | 2017-06-26 |
| 1770909392 | Emmanuel Thierry Mentor | Family Medicine | 650 Dickinson Rd, Chesterton, IN 46304-3387 | 2014-03-06 |
| 1598106585 | Shalini Patel | Family Medicine | 650 Dickinson Rd, Suite A, Chesterton, IN 46304-3387 | 2013-07-08 |
| 1255778627 | Sarah Knapp | Registered Nurse | 650 Dickinson Rd, Chesterton, IN 46304-3387 | 2013-05-25 |
| 1851652820 | Lisa R Stephenson | Nurse Practitioner | 650 Dickinson Rd, Chesterton, IN 46304 | 2012-06-06 |
| 1316119837 | Rodney Lewis Guimont Jr. | Family Medicine | 650 Dickinson Rd, Chesterton, IN 46304-3387 | 2008-03-25 |
| 1508075680 | Porter Physician Services LLC | Nurse Practitioner | 650 Dickinson Rd, Suite A, Chesterton, IN 46304-3387 | 2007-05-22 |
| 1154383693 | Joel Irvin Hull | Family Medicine | 650 Dickinson Rd, Suite A, Chesterton, IN 46304-3387 | 2006-04-03 |
| 1669433256 | Patrick Daniel Fleming | Family Medicine | 650 Dickinson Rd, Suite A, Chesterton, IN 46304-3387 | 2006-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184274268 | Trinity Healthcare Inc. | Occupational Therapist | 2300 Village Point, Chesterton, IN 46304 | 2019-09-19 |
| 1962987206 | Kara Polus | Physical Therapy Assistant | 1595 S Calumet Rd Suite 3, Chesterton, IN 46304 | 2018-10-02 |
| 1275024481 | Karson Rice | Developmental Therapist | 1595 S Calumet Rd, Suite 3, Chesterton, IN 46304 | 2018-05-23 |
| 1720527765 | Alina Broski I | Occupational Therapy Assistant | 1120 S. Calument Road, Suite 3, Chesterton, IN 46304 | 2017-02-22 |
| 1538612015 | Muhammad Ziad Souqiyyeh | Internal Medicine | 3100 Village Pt Ste 102, Chesterton, IN 46304 | 2016-08-01 |
| 1942671656 | Samantha Stremich | Psychologist | 1496 Pope Ct # 2, Chesterton, MI 46304 | 2015-10-08 |
| 1669852299 | Deborah Joan Krause | Physical Therapy Assistant | 780 Dickinson Rd., Addison Pointe Health & Rehab Center, Chesterton, IN 46304 | 2015-06-09 |
| 1538462338 | Sunil Patel Md. P.C. | Internal Medicine | 1140 S. Calumet Road, Suite #2, Chesterton, IN 46304 | 2010-12-16 |
| 1629301981 | Lindsay Allison Munden | Nurse Practitioner | 505 County Road 1100 North, Chesterton, IN 46304 | 2009-09-17 |
| 1881851509 | Total Renal Care Inc | Clinic/Center | 711 Plaza Dr, Ste 6, Chesterton, IN 46304 | 2008-05-20 |
| Find all providers in zip 46304 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487652079 | James A Malayter | Orthopaedic Surgery | 601 Gateway Blvd, Chesterton, IN 46304 | 2005-07-08 |
| 1295733889 | Paul J Gruszka | Orthopaedic Surgery | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2005-07-08 |
| 1558771030 | Tyler Charles Miller | Orthopaedic Surgery | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2014-05-05 |
| 1104143627 | Eric Kristian Szczesniak | Orthopaedic Surgery | 601 Gateway Blvd N, Apt. 409, Chesterton, IN 46304-9658 | 2010-04-23 |
| 1750584249 | Aaron G Anderson | Orthopaedic Surgery | 601 Gateway Boulevard, Chesterton, IN 46304 | 2007-06-11 |
| 1386671345 | Anthony C Levenda | Orthopaedic Surgery | 601 Gateway Boulevard, Chesterton, IN 46304 | 2006-06-27 |
| 1487655163 | Nikola Nenadovich | Orthopaedic Surgery | 601 Gateway Boulevard, Chesterton, IN 46304 | 2005-08-03 |
| 1346248788 | Bruce J Thoma | Orthopaedic Surgery | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2005-07-11 |
| 1104824796 | Thomas H Kay | Orthopaedic Surgery | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2005-07-08 |
| 1467450064 | David J Musgrave | Orthopaedic Surgery | 601 Gateway Blvd N, Chesterton, IN 46304-9658 | 2005-07-08 |
| Find all providers in CHESTERTON | ||||
| City | CHESTERTON |
| Zip Code | 46304 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.