INDIANA UNIVERSITY HEALTH LA PORTE PHYSICIANS INC NPI 1760593776

NPI Information

NPI: 1760593776
Provider Name: INDIANA UNIVERSITY HEALTH LA PORTE PHYSICIANS INC

Former Legal Business Name: LA PORTE REGIONAL PHYSICIAN NETWORK INC

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
1007 LINCOLNWAY
LA PORTE, IN
ZIP 46350
Phone: (219) 326-2489
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INDIANA UNIVERSITY HEALTH LA PORTE PHYSICIANS INC is a multi-specialty clinic center in La Porte, IN. INDIANA UNIVERSITY HEALTH LA PORTE PHYSICIANS INC NPI is 1760593776. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is La Porte Regional Physician Network Inc.

The provider's business location address is:

1007 LINCOLNWAY
LA PORTE, IN
ZIP 46350-201
Phone: (219) 326-2489
Fax: (219) 326-2584

The provider's authorized official is Brian Donnelly .
The authorized official title is Vp Of Strategy & Ambulatory Service and has the following contact phone number (219) 325-4682.

The CLIA number assigned to this NPI record is 15D0948194 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/31/2006 and was last updated on 5/22/2014.

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	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	100165070	MEDICAID	INDIANA
2	153857	MEDICARE OSCAR/CERTIFICATION	INDIANA
3	200988350	MEDICAID	INDIANA
4	151020	MEDICARE PIN	INDIANA
5	0478230001	MEDICARE NSC	INDIANA
6	200255890	MEDICAID	INDIANA

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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