NORTHSHORE HEALTH CENTERS INC. NPI 1295498947

NPI Information

NPI: 1295498947
Provider Name: NORTHSHORE HEALTH CENTERS, INC.
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 15D2300219

Address:
200 3RD CT SE
DEMOTTE, IN
ZIP 46310
Phone: (219) 763-8112
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NORTHSHORE HEALTH CENTERS, INC. is a federally qualified health center (fqhc) clinic center in Demotte, IN. NORTHSHORE HEALTH CENTERS, INC. NPI is 1295498947. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

200 3RD CT SE
DEMOTTE, IN
ZIP 46310-400
Phone: (219) 763-8112

The provider's authorized official is David Hall .
The authorized official title is Ceo and has the following contact phone number (219) 763-8112.

The CLIA number assigned to this NPI record is 15D2300219 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/20/2021 and was last updated on 10/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	208000000X	Pediatrics		No
2	363LF0000X	Nurse Practitioner	Family	No
3	363LW0102X	Nurse Practitioner	Women's Health	No
4	207Q00000X	Family Medicine		No
5	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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