DR. JOHN MIRRO (NPI# 1689678955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689678955 |
| Entity Type | Individual |
| Full Name | DR. JOHN MIRRO |
| Credential | MD |
| Practice Address |
8895 Broadway Merrillville IN 46410-7037 |
| Mailing Address |
Po Box 1293 Bedford Park IL 60499-1293 |
| Practice Telephone | 2197382081 |
| Practice Fax Number | 2197364658 |
| Mailing Telephone | 2609691950 |
| Mailing Fax Number | 2609182137 |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2011-06-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
01024382A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM BC/BS | 000000085025 | 01 |
| IN | RAILROAD MEDICARE | 110044492 | 01 |
| IL | ANTHEM BC/BS | 9115389 | 01 |
| IN | 100187310A | 05 |
| Street Address |
8895 BROADWAY |
| City | MERRILLVILLE |
| State | IN |
| Zip Code | 46410-7037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356343578 | Ahmad Bassel Shughoury | Internal Medicine | 8895 Broadway, Merrillville, IN 46410-7037 | 2005-06-01 |
| 1346601168 | Krystal Lee Baum | Registered Nurse | 8895 Broadway, Merrillville, IN 46410-7037 | 2016-03-08 |
| 1841524683 | Yun Ju Kim | Internal Medicine | 8895 Broadway, Merrillville, IN 46410-7037 | 2009-09-27 |
| 1336165406 | Kathryn M Gjeldum | Nurse Practitioner | 8895 Broadway, Merrillville, IN 46410-7037 | 2006-07-14 |
| 1679508410 | Marianne K Schallmo | Nurse Practitioner | 8895 Broadway, Merrillville, IN 46410-7037 | 2006-07-11 |
| 1235160938 | Ima Endoscopy Surgicenter P C | Clinic/Center | 8895 Broadway, Merrillville, IN 46410-7037 | 2006-07-05 |
| 1487685178 | Internal Medicine Associates | Internal Medicine | 8895 Broadway, Merrillville, IN 46410-7037 | 2006-07-05 |
| 1922076702 | Tamara Joy Elkins | Nurse Practitioner | 8895 Broadway, Merrillville, IN 46410 | 2006-03-09 |
| 1992770390 | Mark Fesenmyer | Internal Medicine | 8895 Broadway, Merrillville, IN 46410-7037 | 2006-02-20 |
| 1225013972 | Omar Said Nehme | Internal Medicine | 8895 Broadway, Merrillville, IN 46410-7037 | 2005-12-14 |
| 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 | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235216425 | Rahul Naresh Julka | Internal Medicine | 5825 Broadway Suite B, Merrillville, IN 46410-2664 | 2006-11-01 |
| 1679521827 | Richard H. Hsu | Internal Medicine | 5825 Broadway, Suiteb, Merrillville, IN 46410-2687 | 2006-05-04 |
| 1356343578 | Ahmad Bassel Shughoury | Internal Medicine | 8895 Broadway, Merrillville, IN 46410-7037 | 2005-06-01 |
| 1790901940 | Navin Kumar | Internal Medicine | 5825 Broadway, Suite B, Merrillville, IN 46410-2664 | 2007-04-17 |
| 1992770390 | Mark Fesenmyer | Internal Medicine | 8895 Broadway, Merrillville, IN 46410-7037 | 2006-02-20 |
| 1326043597 | Peter George Mavrelis | Internal Medicine | 8895 Broadway, Merrillville, IN 46410-7037 | 2005-06-15 |
| 1154325421 | Kumar Venkatachalam | Internal Medicine | 8895 Broadway, Merrillville, IN 46410-7037 | 2005-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710486295 | Gastro Md, LLC | Internal Medicine | 625 Richland Way, Westfield, IN 46074-9054 | 2018-02-09 |
| 1790137115 | Abdinoor Medical LLC | Internal Medicine | 1819 Braemar Dr, Fort Wayne, IN 46814-9364 | 2016-07-09 |
| 1538578018 | Shail Sheth | Internal Medicine | 3903 S 7th St Ste 2f, Terre Haute, IN 47802-5710 | 2014-08-08 |
| 1992113245 | Unity Healthcare, LLC | Internal Medicine | 1345 Unity Pl Ste 110, Lafayette, IN 47905-5768 | 2014-07-31 |
| 1265773113 | Michael Sai Lai Sey | Internal Medicine | 550 N. University Blvd, Suite 4100, Indiana University Hospital, Indianapolis, IN 46202 | 2013-03-01 |
| 1649531062 | Kavish Rohit Patidar | Internal Medicine | 702 Rotary Cir Ste 225, Indianapolis, IN 46202-5133 | 2012-06-01 |
| 1265726673 | Digestive Healthcare Specialists LLC | Internal Medicine | 8865 W 400 N Ste 155, Michigan City, IN 46360-9010 | 2011-06-02 |
| 1033442991 | Dana Charles Moffatt | Internal Medicine | 359 N West St, Apt 284, Indianapolis, IN 46202-4207 | 2009-09-10 |
| 1134356173 | Robert G. Overstreet | Internal Medicine | 348 Bohart Ln, Charlestown, IN 47111-1606 | 2009-06-17 |
| 1003057993 | John Charles Lowe Sr. | Internal Medicine | 10912 300 Yard Dr, Fishers, IN 46037-9306 | 2009-03-23 |
| 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.