TERRY EBERT, MD, INC (NPI# 1417173717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417173717 |
| Entity Type | Organization |
| Organization Name | TERRY EBERT, MD, INC |
| Practice Address |
509 Ridge Rd Suite 1 Munster IN 46321-1643 |
| Practice Telephone | 2198361050 |
| Practice Fax Number | 2198364969 |
| Mailing Telephone | 2198361050 |
| Mailing Fax Number | 2198364969 |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2010-11-15 |
| Authorized Official Name | DR. TERRY W EBERT (PRESIDENT) |
| Authorized Official Telephone | 2198361050 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
01022150A | IN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | DEA REGISTRATION NUMBER | AE6711926 | 01 |
| PHYSICIAN LICENSE NUMBER | 01022150A | 01 | |
| IN | CORPORATION REGISTRATION | 50001124A | 01 |
| Street Address |
509 RIDGE RD SUITE 1 |
| City | MUNSTER |
| State | IN |
| Zip Code | 46321-1643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700992625 | Terry Wayne Ebert | Specialist | 509 Ridge Rd, Suite 1, Munster, IN 46321-1643 | 2006-08-22 |
| 1255755245 | Stand Up Open Mri of Indiana LLC | Clinic/Center | 509 Ridge Rd, Munster, IN 46321-1643 | 2014-02-11 |
| 1871880112 | Adult and Pediatric Eye Specialists Corp | Ophthalmology | 509 Ridge Rd, Suite #3, Munster, IN 46321-1643 | 2011-07-07 |
| 1972646461 | David M Radovich | Dentist | 509 Ridge Rd, Munster, IN 46321-1643 | 2007-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154959179 | Munster Surgery Center LLC | Clinic/Center | 1950 45thstreet, Unit 101, Munster, IN 46321 | 2020-03-27 |
| 1467092668 | Barbara Armstrong-whitaker | Counselor | 8855 Columbia Ave, Munster, IN 46321 | 2020-01-15 |
| 1427537661 | Courtney Szydelko | Physical Therapist | 759 45th St Ste 202, Munster, IN 46321 | 2018-08-08 |
| 1407341787 | New Harvest Therapy Services, Inc. | Clinic/Center | 8124 Calumet Ave Ste B, Munster, IN 46321 | 2018-06-28 |
| 1043717945 | Region Eye Care LLC | Optometrist | 10413 Calumet Ave., Munster, IN 46321 | 2018-04-09 |
| 1003318122 | Jean M Nanos | Psychologist | 8124 Calumet Ave, Munster, IN 46321 | 2018-03-05 |
| 1841706330 | Avalon Marciniak | Speech-Language Pathologist | 1950 West 45th St., Munster, IN 46321 | 2017-12-19 |
| 1104330034 | Hinsdale Orthopaedic Associates, S.c. | Orthopaedic Surgery | 8141 S Calumet Ave, Unit 1, Munster, IN 46321 | 2017-11-30 |
| 1457871774 | Shannon Nicole Riley | Behavior Technician | 8113 Howard Ave., Munster, IN 46321 | 2017-06-27 |
| 1679017313 | Infomedica | Internal Medicine | 10010 Donald S Powers Dr, Munster, IN 46321 | 2016-12-15 |
| Find all providers in zip 46321 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285164509 | Better Quality of Life Care Md, PC | Clinic/Center | 8334 Beech Ave, Munster, IN 46321-1440 | 2017-06-19 |
| 1639622236 | Fordem Health, LLC | Clinic/Center | 1313 Park Dr, Munster, IN 46321-2634 | 2016-07-31 |
| 1659439115 | Calumet Internist PC | Clinic/Center | 9122 Columbia Ave, Munster, IN 46321-2907 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326654070 | Providence Medical Associates LLC | Clinic/Center | 1935 N Capitol Ave Ste 107, Indianapolis, IN 46202-6403 | 2020-09-18 |
| 1447866462 | Firstlines, Tjs, LLC | Clinic/Center | 11725 Illinois St Ste 550, Carmel, IN 46032-3009 | 2020-09-16 |
| 1902429251 | Telacare Health Solutions, LLC | Clinic/Center | 11650 Olio Rd Ste 1000-172, Fishers, IN 46037-7619 | 2020-05-21 |
| 1275001489 | Decatur County Memorial Hospital | Clinic/Center | 955 N Michigan Ave Ste 2, Greensburg, IN 47240-1487 | 2018-11-06 |
| 1447619747 | Sanford Dermatology | Clinic/Center | 400 W Green Meadows Dr Ste 110, Greenfield, IN 46140-3205 | 2016-02-15 |
| 1306222757 | Midwest Wellness LLC | Clinic/Center | 6822 E 82nd St Ste 310, Indianapolis, IN 46250-1677 | 2015-08-08 |
| 1053657775 | Earthen Vessels Nurse Midwifery LLC | Clinic/Center | 251 Airport North Office Park, Fort Wayne, IN 46825-6702 | 2012-12-27 |
| 1861757023 | Integrative Therapeutics LLC | Clinic/Center | 11074 Woods Bay Ln, Indianapolis, IN 46236-9020 | 2012-07-12 |
| 1093953234 | Wabash Valley Infectious Diseases Clinic LLC | Clinic/Center | 2112 S 3rd St, Terre Haute, IN 47802-3045 | 2009-01-27 |
| 1790966331 | Robert L Brunk II Do PC | Clinic/Center | 505 Robinhood Ct, Valparaiso, IN 46385-8021 | 2007-11-26 |
| Find all providers with the same taxonomy | ||||
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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.