NORTHSHORE HEALTH CENTERS, INC. (NPI# 1477810315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477810315 |
| Entity Type | Organization |
| Organization Name | NORTHSHORE HEALTH CENTERS, INC. |
| Other Organization Name | MERRILLVILLE HEALTH CENTER |
| Practice Address |
6091 Broadway Merrillville IN 46410-2619 |
| Mailing Address |
Po Box 1430 Portage IN 46368-9230 |
| Practice Telephone | 2197638112 |
| Practice Fax Number | 2198842547 |
| Mailing Telephone | 2197638112 |
| Mailing Fax Number | 2197645380 |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2020-09-22 |
| Authorized Official Name | DAVID HALL (CEO) |
| Authorized Official Telephone | 2197638112 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| N | 124Q00000X | Dental Hygienist | Dental Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | MEDICARE PART A PTAN | 151880 | 01 |
| IN | 200331170G | 05 | |
| IN | MEDICARE PART B PTAN | 191360 | 01 |
| Other Name | Type Code |
|---|---|
| Merrillville Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740887298 | Northshore Health Centers, Inc. | Family Medicine | 651 W Morgan Ave Rm F168, Chesterton, IN 46304-2243 | 2020-10-07 |
| 1972895647 | Northshore Health Centers, Inc. | Family Medicine | 3304 Parkside Ave, Lake Station, IN 46405-1143 | 2011-05-12 |
| 1578864948 | Northshore Health Centers, Inc. | Counselor | 1008 Broadway, Chesterton, IN 46304-2149 | 2010-11-16 |
| 1497995815 | Northshore Health Centers, Inc. | Pharmacy | 2490 Central Ave Ste B, Lake Station, IN 46405-2122 | 2009-02-25 |
| 1467490300 | Northshore Health Centers, Inc. | Family Medicine | 6450 Us Highway 6, Portage, IN 46368-5110 | 2006-06-03 |
| 1417519000 | Northshore Health Centers, Inc. | Counselor | 714 Lincolnway, La Porte, IN 46350-3353 | 2019-07-03 |
| 1568856045 | Northshore Health Centers, Inc. | Obstetrics & Gynecology | 407 W Indiana Ave, Chesterton, IN 46304-2350 | 2015-03-24 |
| 1598196933 | Northshore Health Centers, Inc. | Family Medicine | 276 E 68th Pl, Merrillville, IN 46410-3566 | 2013-12-11 |
| 1861636664 | Northshore Health Centers, Inc. | Counselor | 2490 Central Ave, Lake Station, IN 46405-2122 | 2009-04-23 |
| 1356530505 | Northshore Health Centers, Inc. | Dentist | 3099 Central Ave, Lake Station, IN 46405-2207 | 2007-10-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTHSHORE HEALTH CENTERS, INC | 6450 Us Highway 6, Portage, IN 46368-5110 |
| Street Address |
6091 BROADWAY |
| City | MERRILLVILLE |
| State | IN |
| Zip Code | 46410-2619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568482404 | Madhumita Bhojraj | Family Medicine | 6091 Broadway, Merrillville, IN 46410-2619 | 2006-07-21 |
| 1942658497 | Maya Janay Dominique | Obstetrics & Gynecology | 6091 Broadway, Merrillville, IN 46410-2619 | 2016-05-25 |
| 1477930022 | Emilia J Blaser | Dentist | 6091 Broadway, Merrillville, IN 46410-2619 | 2015-05-04 |
| 1487049813 | Matthew Jason Tipton | Obstetrics & Gynecology | 6091 Broadway, Merrillville, IN 46410-2619 | 2015-04-02 |
| 1952792236 | Charlotte R Radic | Advanced Practice Midwife | 6091 Broadway, Merrillville, IN 46410-2619 | 2015-02-09 |
| 1164861324 | Ravi Kumar Vijay Patel | Dentist | 6091 Broadway, Merrillville, IN 46410-2619 | 2013-06-21 |
| 1457697898 | Leah Michelle Johnson-williams | Nurse Practitioner | 6091 Broadway, Merrillville, IN 46410-2619 | 2012-12-12 |
| 1164661922 | Faiqa Mohyuddin | Pediatrics | 6091 Broadway, Merrillville, IN 46410-2619 | 2009-02-18 |
| 1770615387 | Ronda Lynn Wilson-carr | Social Worker | 6091 Broadway, Merrillville, IN 46410-2619 | 2007-03-09 |
| 1942216478 | Deborah L Mccullough | Obstetrics & Gynecology | 6091 Broadway, Merrillville, IN 46410-2619 | 2006-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023636867 | Lena Danielle Clouse | Pharmacist | Genoa Healthcare LLC, 8555 Taft Street, Merrillville, IN 46410 | 2020-07-08 |
| 1134752728 | All In One Therapy, LLC | Speech-Language Pathologist | 1800 W 84th Drive, Merrillville, IN 46410 | 2020-02-21 |
| 1134759335 | David John Kujawa | Social Worker | 8398 Mississippi St., Merrillville, IN 46410 | 2020-01-16 |
| 1619513603 | Activate Healthcare - Plumbers Local 210 Clinic | Clinic/Center | 2905 E 83rd Place, Merrillville, IN 46410 | 2019-11-25 |
| 1568946994 | Larry Smith | Case Manager/Care Coordinator | 233 E 83, Merrillville, IN 46410 | 2018-09-21 |
| 1114401536 | The Sheet People | Durable Medical Equipment & Medical Supplies | 8874 Louisiana Street, Merrillville, IN 46410 | 2018-09-21 |
| 1659858439 | Heather Grinder | Hearing Instrument Specialist | 9120 Connecticut Dr., Suite C, Merrillville, IN 46410 | 2018-07-24 |
| 1710463872 | Mitchell G Smith | Optometrist | 1601 E 81st Ave, Merrillville, IN 46410 | 2018-07-12 |
| 1336631753 | Nwi Mobility, Inc. | Durable Medical Equipment & Medical Supplies | 1454 E. 86th Place, Merrillville, IN 46410 | 2018-06-01 |
| 1659860427 | Wendell B Fleming | Counselor | 230 West 175th Place, Apartment I, Merrillville, IN 46410 | 2018-05-07 |
| Find all providers in zip 46410 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477007292 | Southlake Community Mental Health Center, Inc. | Clinic/Center | 8555 Taft St, Merrillville, IN 46410-6123 | 2016-08-10 |
| 1952660243 | Community Healthnet Inc | Clinic/Center | 6100 Broadway, Merrillville, IN 46410-3002 | 2012-05-08 |
| 1154689750 | Community Healthnet, Inc | Clinic/Center | 8679 Connecticut St, Suite C, Merrillville, IN 46410-6386 | 2012-05-02 |
| 1114257300 | Northshore Health Centers Inc | Clinic/Center | 8555 Taft St, Merrillville, IN 46410-6123 | 2010-01-11 |
| 1568525244 | Grand Park Surgical Center, Inc | Clinic/Center | 1479 E 84th Pl, Merrillville, IN 46410-6451 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548861313 | Edgewater Systems for Balanced Living, Inc | Clinic/Center | 1100 W 5th Ave, Gary, IN 46402-1723 | 2020-11-06 |
| 1205446259 | Hamilton Center Inc. | Clinic/Center | 622 8th Avenue, Terre Haute, IN 47804-4780 | 2020-08-05 |
| 1023626744 | Meridian Health Services Corp. | Clinic/Center | 801 N Walnut St # 1, Muncie, IN 47305-1458 | 2020-07-20 |
| 1316573413 | Meridian Health Services Corp. | Clinic/Center | 1601 E 26th St # 6, Muncie, IN 47302-5808 | 2020-03-20 |
| 1477188217 | The Health and Hospital Corporation of Marion County | Clinic/Center | 1112 Southeastern Ave, Indianapolis, IN 46202-3947 | 2020-03-11 |
| 1023642576 | Southlake Community Mental Health Center Inc. | Clinic/Center | 2250 173rd St Ste 111, Hammond, IN 46323-2074 | 2020-02-24 |
| 1053944058 | 219 Health Network Inc | Clinic/Center | 1802 E Columbus Dr, East Chicago, IN 46312-2826 | 2020-02-18 |
| 1225661234 | 219 Health Network Inc | Clinic/Center | 4320 Fir St Unit 208, East Chicago, IN 46312-8410 | 2020-02-18 |
| 1578194049 | Meridian Health Services Corp | Clinic/Center | 520 S 9th St Ste A, Richmond, IN 47374-6230 | 2020-02-03 |
| 1023671740 | Open Door Health Services, Inc. | Clinic/Center | 1804-1806 West Royale Dr, Muncie, IN 47304-2243 | 2019-04-18 |
| Find all providers with the same taxonomy | ||||
| City | MERRILLVILLE |
| Zip Code | 46410 |
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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.