COMMUNITY CARE NETWORK, INC (NPI# 1568776060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568776060 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CARE NETWORK, INC |
| Other Organization Name | INNOVATIVE WOMENS HEALTH |
| Practice Address |
3545 Arbors St Portage IN 46368-4297 |
| Mailing Address |
1500 S Lake Park Ave Managed Care Department Hobart IN 46342-6638 |
| Practice Telephone | 2197596092 |
| Practice Fax Number | 2197596092 |
| Mailing Telephone | 2199476613 |
| Mailing Fax Number | 2199476503 |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2013-01-04 |
| Authorized Official Name | DONALD P FESKO (CEO) |
| Authorized Official Telephone | 2198361600 |
| Is Organization Subpart | Y |
| Parent Organization Name | MUNSTER MEDICAL RESEARCH FOUNDATION INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| INNOVATIVE WOMENS HEALTH | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831501212 | Community Care Network, Inc | Family Medicine | 3432 169th St, Hammond, IN 46323-2542 | 2014-05-20 |
| 1790156214 | Community Care Network, Inc | Podiatrist | 6375 Us Highway 6, Suite D, Portage, IN 46368-5217 | 2015-10-09 |
| 1952790321 | Community Care Network, Inc | Orthopaedic Surgery | 7835 Grand Blvd, Hobart, IN 46342-6665 | 2015-01-22 |
| 1538576350 | Community Care Network, Inc | Internal Medicine | 3800 Saint Mary Rd, Suite 103, Valparaiso, IN 46383-3986 | 2014-07-14 |
| 1629480686 | Community Care Network, Inc | Family Medicine | 9660 Wicker Ave, Saint John, IN 46373-9487 | 2014-05-27 |
| 1689086001 | Community Care Network, Inc | Family Medicine | 3800 Saint Mary Rd, Suite 102, Valparaiso, IN 46383-3986 | 2014-05-21 |
| 1912319393 | Community Care Network, Inc | Family Medicine | 7651 Harvest Dr, Schererville, IN 46375-3476 | 2014-05-20 |
| 1245667773 | Community Care Network, Inc | Urology | 3800 Saint Mary Rd, Suite 205, Valparaiso, IN 46383-3986 | 2013-09-30 |
| 1528495058 | Community Care Network, Inc | Urology | 10607 Randolph St, Suite C, Crown Point, IN 46307-7504 | 2013-09-30 |
| 1689000705 | Community Care Network, Inc | Orthopaedic Surgery | 4320 Fir St, Suite 201, East Chicago, IN 46312-3052 | 2013-09-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | COMMUNITY CARE NETWORK, INC. | 5251 Viewridge Ct., San Diego, CA 92123 |
| Connecticut Business Registrations | COMMUNITY CARE NETWORK, INC. | Po Box 750, Nashville, TN 37202-0750 |
| Washington State Corporations | COMMUNITY CARE NETWORK, INC. | 300 Deschutes Way Sw Ste 208 Mc-csc1, Tumwater, WA 98501 |
| Oklahoma Business Registrations | COMMUNITY CARE NETWORK, INC. | 5251 Viewridge Ct, San Diego, CA 92123 |
| Indiana Business Entities | COMMUNITY CARE NETWORK, INC. | 5251 Viewridge Ct., San Diego, CA 92123 |
| Street Address |
3545 ARBORS ST |
| City | PORTAGE |
| State | IN |
| Zip Code | 46368-4297 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1831576693 | Bishara Robert Khoury | Family Medicine | 3545 Arbor Blvd Ste E, Portage, IN 46368 | 2015-04-30 |
| 1962813535 | Diane Farrington | Pharmacist | 6050 Us Hwy 6, Portage, IN 46368 | 2014-05-16 |
| 1588827562 | Jennifer Ann Rumpel | Allergy & Immunology | 6375 Us Highway 6 Ste C, Portage, IN 46368 | 2008-07-09 |
| 1588822688 | Total Renal Care Inc | Clinic/Center | 5823 Us Highway 6, Portage, IN 46368 | 2008-05-27 |
| 1235321480 | Michael Wendahl | Physical Therapist | 3691 Willowcreek Road, Suite 100, Portage, IN 46368 | 2007-08-13 |
| 1679663603 | Stephen V Headley | Family Medicine | 3283 Willowcreek Rd, Portage, IN 46368 | 2006-10-13 |
| 1730276486 | Robert Tan Ang | Psychiatry & Neurology | 3156 Willowcreek Road, Portage, IN 46368 | 2006-10-06 |
| 1013029883 | Primary Care PC | Family Medicine | 3125 Willowcreek Road, Portage, IN 46368 | 2006-08-31 |
| 1104936962 | Margaret Eileen Griffith | Dentist | 2646 Lois Street, Portage, IN 46368 | 2006-08-30 |
| Find all providers in zip 46368 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| 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 Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992870398 | The Woman's Wellness Center, P.C. | Obstetrics & Gynecology | 3630 Willowcreek Road, Suite 10, Portage, IN 46368-5075 | 2006-11-21 |
| 1033162425 | Travis Haldeman | Obstetrics & Gynecology | 3545 Arbor Blvd, Portage, IN 46368-4298 | 2006-05-18 |
| 1801852165 | Daniel Lawrence Lott | Obstetrics & Gynecology | 3564 Scottsdale St, Portage, IN 46368-5420 | 2006-04-25 |
| 1649250242 | Scott M Peterson | Obstetrics & Gynecology | 3300 W Centre Ave, Bronson Ob Gyn Associates, Portage, MI 49024-4666 | 2006-01-19 |
| 1083976682 | Sara Lynn Deatsman | Obstetrics & Gynecology | 3300 W Centre Ave, Portage, MI 49024-4666 | 2012-06-11 |
| 1538459813 | Amber Rachelle Nash-guilford | Obstetrics & Gynecology | 7895 Currier Dr, Portage, MI 49002-4314 | 2011-04-08 |
| 1083925333 | St Mary Medical Center Inc | Obstetrics & Gynecology | 3545 Arbors Street, Portage, IN 46368-4297 | 2010-07-01 |
| 1689841165 | Women's Medical Care LLC | Obstetrics & Gynecology | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2008-05-13 |
| 1285856245 | Jessica Lynn Puckett | Obstetrics & Gynecology | 3300 W Centre Ave, Portage, MI 49024-4666 | 2007-05-02 |
| 1952453474 | Jennifer Margaret Carman | Obstetrics & Gynecology | 3300 W Centre Ave, Portage, MI 49024-4666 | 2007-01-17 |
| Find all providers in PORTAGE | ||||
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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.