NPIMap

Organization Active NPI

Porter-Starke Services Inc

  • Federally Qualified Health Center (FQHC)
  • Gary, IN
National Provider Identifier
1003371220
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PORTER-STARKE SERVICES INC
Practice address
Marram Health Center
3229 Broadway Suite 160
Gary, IN 46409-1040
Phone
(219) 806-3011
NPI assigned
Feb 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Aileen Wehren
Title
VP Systems Administration
Phone
(219) 476-4567

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

Marram Health Center
3229 Broadway Suite 160
Gary, IN 46409-1040

Mailing address

601 Wall St
Valparaiso, IN 46383-2512
Phone (219) 806-3011

Other names 1

  • MARRAM HEALTH CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040330000098 IN Part B Supplier - Clinic/Group Practice 1951293554 Receives reassigned benefits from 108 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Valparaiso, IN; Portage, IN; Knox, IN; Gary, IN; Hebron, IN
O20190213000852 IN Part A Provider - Federally Qualified Health Center (FQHC) 1951293554 Practice locations: Gary, IN

Federally qualified health center certification: CCN 151038

Legal name
PORTER-STARKE SERVICES INC
Doing business as
MARRAM HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 12, 2019
Last certification
Feb 12, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 24, 1967 in IN
Enrollment address
3229 Broadway
Ste 160
Gary, IN 46409

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Porter-Starke Services Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Clarence Boykin Individual Corporate OfficerVP, Marram Health Centers Jan 16, 2018
W-2 Managing EmployeeVP, Marram Health Centers Jan 16, 2018
Andrew Nielsen Individual Corporate OfficerCfo Jan 16, 2018
W-2 Managing EmployeeCfo Jan 16, 2018
Mark Goodrich Individual Corporate OfficerVP, Human Resources Jan 16, 2018
W-2 Managing EmployeeVP, Human Resources Jan 16, 2018
Kate Sanders Individual Corporate OfficerVP, Systems Administration Jan 16, 2018
W-2 Managing EmployeeVP, Systems Administration Jan 16, 2018
Sandra Ruth Carlson Individual Corporate OfficerVP, Clinical Services Jan 16, 2018
W-2 Managing EmployeeVP, Clinical Services Jan 16, 2018
Michael Weaver Individual Corporate OfficerVP, Medical Services Jan 16, 2018
W-2 Managing EmployeeVP, Medical Services Jan 16, 2018
Matthew Burden Individual Corporate OfficerCeo Dec 29, 2017
Corporate DirectorCeo Dec 29, 2017
W-2 Managing EmployeeCeo Dec 29, 2017
Operational/Managerial ControlCeo Dec 29, 2017

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Porter Starke Services IncValparaiso, IN, CCN 154052 Hospital Operational/Managerial Control
Other		 Jul 24, 1967
Jul 24, 1967
Marram Health CenterGary, IN, CCN 151956 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 27, 2015
Marram Health CenterHebron, IN, CCN 151051 Federally qualified health center 5% Or Greater Direct Ownership Interest Jul 24, 1967

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 44

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1003371220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 WALL ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832512",
            "telephone_number": "219-806-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARRAM HEALTH CENTER",
            "address_2": "3229 BROADWAY SUITE 160",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464091040",
            "telephone_number": "219-806-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTER-STARKE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-01",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "WEHREN",
        "authorized_official_first_name": "AILEEN",
        "authorized_official_title_or_position": "VP SYSTEMS ADMINISTRATION",
        "authorized_official_telephone_number": "219-476-4567"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARRAM HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MARRAM HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gary, IN

Sources for this page

Verify at the official NPI Registry.