COMMUNITY CARE NETWORK, INC (NPI# 1629480686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629480686 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CARE NETWORK, INC |
| Practice Address |
9660 Wicker Ave Saint John IN 46373-9487 |
| Mailing Address |
1500 S Lake Park Ave Managed Care Department Hobart IN 46342-6638 |
| Practice Telephone | 2193651166 |
| Practice Fax Number | 2193658852 |
| Mailing Telephone | 2199476113 |
| Mailing Fax Number | 2199476503 |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-05-27 |
| Authorized Official Name | RICHARD BUCHLER (DIRECTOR) |
| Authorized Official Telephone | 2199346113 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | IN | Allopathic & Osteopathic Physicians | |
| Y | 207P00000X | Emergency Medicine | IN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831501212 | Community Care Network, Inc | Family Medicine | 3432 169th St, Hammond, IN 46323-2542 | 2014-05-20 |
| 1568776060 | Community Care Network, Inc | Urology | 3545 Arbors St, Portage, IN 46368-4297 | 2010-07-27 |
| 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 |
| 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 |
| Colorado Business Entities | COMMUNITY CARE NETWORK, INC. | 5251 Viewridge Court, San Diego, CA 92123 |
| Street Address |
9660 WICKER AVE |
| City | SAINT JOHN |
| State | IN |
| Zip Code | 46373-9487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255335816 | Robert P Chen | Internal Medicine | 9660 Wicker Ave, Saint John, IN 46373-9487 | 2005-06-10 |
| 1457825325 | Joanne Weisz | Nurse Practitioner | 9660 Wicker Ave, Saint John, IN 46373-9487 | 2019-01-14 |
| 1093284838 | Alicia Fowler | Nurse Practitioner | 9660 Wicker Ave, Saint John, IN 46373-9487 | 2018-11-22 |
| 1306330071 | Latrese Smith-wynn | Physical Therapist | 9660 Wicker Ave, Saint John, IN 46373-9487 | 2018-06-18 |
| 1528558889 | John Marc Vander Veer | Physical Therapist | 9660 Wicker Ave, Saint John, IN 46373-9487 | 2018-05-12 |
| 1407343817 | Michele Kaluf | Physical Therapist | 9660 Wicker Ave, Saint John, IN 46373-9487 | 2018-04-20 |
| 1487045399 | Jonathan Ramos | Family Medicine | 9660 Wicker Ave, Saint John, IN 46373-9487 | 2015-02-13 |
| 1326333618 | Joseen A Bryant | Family Medicine | 9660 Wicker Ave, Saint John, IN 46373-9487 | 2011-06-14 |
| 1588989891 | Munster Medical Research Foundation Inc | Family Medicine | 9660 Wicker Ave, Saint John, IN 46373-9487 | 2010-03-30 |
| 1114257599 | Munster Orthopaedic Institute, LLC | Durable Medical Equipment & Medical Supplies | 9660 Wicker Ave, Saint John, IN 46373-9487 | 2010-01-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023641123 | Lisa A Arteaga | Occupational Therapy Assistant | 10700 Park Place of St John, St John, IN 46373 | 2020-02-17 |
| 1306493507 | Athletico Ltd | Physical Therapist | 10081 Wicker Ave #4, Saint John, IN 46373 | 2019-08-22 |
| 1083014971 | Courtney Olavarria | Registered Nurse | 8915 West 93rd Avenue, Clark Middle School, Saint John, IN 46373 | 2014-08-27 |
| 1316368111 | Tracy Lynn Wargo | Registered Nurse | 8801 Wicker Ave., Kolling Elementary, St. John, IN 46373 | 2013-12-20 |
| 1245587989 | Joshua Dejong | Physical Therapist | 10200 Wicker Ave Ste 1, Saint John, IN 46373 | 2012-08-13 |
| 1053406629 | Corlin Alden Stein | Chiropractor | 9161 Wicker Avenue (us 41), St. John, IN 46373 | 2006-10-03 |
| 1235190216 | Tarak R Chokshi | Internal Medicine | 10200 Wicker Avenue, St John, IN 46373 | 2006-03-30 |
| 1154397057 | Norbert A Matulis | Dentist | 9207 Wicker Avenue, St John, IN 46373 | 2006-02-28 |
| 1568462729 | Keith R. Pitchford | Orthopaedic Surgery | 9615 Keilman Street, Saint John, IN 46373 | 2005-07-28 |
| 1528483021 | Creating Smiles PC | Dentist | 8217 Wicker Ave, St John, IN 46373 | 2014-02-20 |
| Find all providers in zip 46373 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770769929 | Brooke Mcdermott | Emergency Medicine | 9660 Wicker Ave, Saint John, IN 46373-9487 | 2008-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396358255 | Vyvian Charlene Lawrence | Emergency Medicine | 5939 W Lincoln Hwy, Crown Point, IN 46307-9604 | 2020-08-28 |
| 1508358128 | Antonino Bucca | Emergency Medicine | 720 Eskenazi Ave Bldg 3, Indianapolis, IN 46202-5187 | 2018-05-30 |
| 1124518931 | Evan Mitchell Landry Tomkiewicz | Emergency Medicine | 720 Eskenazi Ave Fl Ft3, Indianapolis, IN 46202-5187 | 2018-05-16 |
| 1760907299 | Timothy John Howard | Emergency Medicine | 610 1/2 N Main Street, Apartment 1, Mishawaka, IN 46545 | 2017-08-05 |
| 1760913891 | Nathan Francis Marcinkowski | Emergency Medicine | 216 N 4th St Ste 205, Lafayette, IN 47901-1323 | 2017-03-21 |
| 1154777613 | Michael J Bojrab | Emergency Medicine | 6720 Kirkdale Dr, Fort Wayne, IN 46815-5524 | 2016-05-13 |
| 1114307063 | Grant Fabian Chernoby | Emergency Medicine | 701 N Senate Ave # B401, Indianapolis, IN 46202-3111 | 2015-06-05 |
| 1457730830 | Patrick Lee Studtman | Emergency Medicine | 615 N. Michigan Street, Emergency Department, South Bend, IN 46601-1033 | 2015-05-19 |
| 1861888430 | Enola Okonkwo | Emergency Medicine | 9785 Valley Springs Blvd, Fishers, IN 46037-8764 | 2015-04-10 |
| 1518355882 | Marlin R. Gray | Emergency Medicine | 925 N. County Rd., 1100e, Otwell, IN 47564 | 2015-01-08 |
| Find all providers with the same taxonomy | ||||
| City | SAINT JOHN |
| Zip Code | 46373 |
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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.