NORTHSHORE HEALTH CENTERS, INC. (NPI# 1972895647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972895647 |
| Entity Type | Organization |
| Organization Name | NORTHSHORE HEALTH CENTERS, INC. |
| Other Organization Name | NORTHSHORE EDISON SENIOR HIGH SCHOOL |
| Practice Address |
3304 Parkside Ave Lake Station IN 46405-1143 |
| Mailing Address |
Po Box 1430 Portage IN 46368-9230 |
| Practice Telephone | 2197638112 |
| Practice Fax Number | 2199621860 |
| Mailing Telephone | 2197638112 |
| Mailing Fax Number | 2197645380 |
| Enumeration Date | 2011-05-12 |
| 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 | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| 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 B PTAN | 191360 | 01 |
| IN | MEDICARE PART A PTAN | 151874 | 01 |
| IN | 200331170F | 05 |
| Other Name | Type Code |
|---|---|
| NorthShore Edison Senior High School | 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 |
| 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 |
| 1477810315 | Northshore Health Centers, Inc. | Social Worker | 6091 Broadway, Merrillville, IN 46410-2619 | 2012-04-17 |
| 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 |
3304 PARKSIDE AVE |
| City | LAKE STATION |
| State | IN |
| Zip Code | 46405-1143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982041893 | Nanette Lindesmith | Nurse Practitioner | 3304 Parkside Ave, Lake Station, IN 46405 | 2013-05-31 |
| 1215289186 | Kari Payton | Specialist/Technologist | 3304 Parkside Ave, Lake Station, IN 46405-1143 | 2012-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245507748 | Melissa Goldsberry | Pharmacist | 9500 Central Avenue, Lake Station, IN 46405 | 2011-11-28 |
| 1518085992 | Nikki A Wargo Dds | Dentist | 2370 E 37th Ave, Lake Station, IN 46405 | 2007-03-26 |
| 1336214493 | Civil City of Lake Station Ind | Ambulance | 1876 Fairview Ave, Lake Station, IN 46405 | 2006-11-22 |
| 1720511785 | Patience Tieri | Nurse Practitioner | 2490 Central Ave, Lake Station, IN 46405 | 2017-04-06 |
| 1639249212 | Maria Rosario Badar | Internal Medicine | 3820 Central Ave, Lake Station, IN 46405 | 2006-11-09 |
| 1972637171 | Southlake Tricity Rba | Custodial Care Facility | 2075 Ripley St, Lake Station, IN 46405-1161 | 2007-03-16 |
| 1699043190 | Jennifer Marie Legg | Licensed Practical Nurse | 2075 Ripley St, Lake Station, IN 46405-1161 | 2011-12-12 |
| 1689994683 | Charlene Jackson | Licensed Practical Nurse | 2075 Ripley St, Lake Station, IN 46405-1161 | 2010-06-02 |
| 1497995815 | Northshore Health Centers, Inc. | Pharmacy | 2490 Central Ave Ste B, Lake Station, IN 46405-2122 | 2009-02-25 |
| 1578563516 | Shah Alam Chowdhury | Pediatrics | 2490 Central Ave, Lake Station, IN 46405-2122 | 2005-07-29 |
| Find all providers in zip 46405 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
| City | LAKE STATION |
| Zip Code | 46405 |
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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.