Sothlake Children'S Clinic, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01025756 Issued in IN

Legal business name

SOTHLAKE CHILDREN'S CLINIC, LLC

Practice address

8300 Broadway
Suite C
Merrillville, IN 46410-8602

Phone

(219) 738-1916

Fax

(219) 736-5685

NPI assigned

Feb 1, 2012

Organization subpart

No

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

Authorized official

Name

Srikietr Dhana, M.D.NPI 1750371530

Title

Owner

Phone

(219) 738-1916

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Srikietr Dhana, MD

  • Pediatrics Physician
  • Merrillville, IN
  • NPI 1750371530
  NPD (past) Authorized official

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328054400000",
    "number": "1023380342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 BROADWAY",
            "address_2": "SUITE C",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464108602",
            "telephone_number": "219-738-1916",
            "fax_number": "219-736-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 BROADWAY",
            "address_2": "SUITE C",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464108602",
            "telephone_number": "219-738-1916",
            "fax_number": "219-736-5685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOTHLAKE CHILDREN'S CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-01",
        "last_updated": "2012-02-01",
        "status": "A",
        "authorized_official_last_name": "DHANA",
        "authorized_official_first_name": "SRIKIETR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-738-1916",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01025756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100360530A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Solution LLC
• Solution Telehealth
• Tolanda Somerville-Philpotts, M.S.CCC-SLP
• Jennifer Sommers
• Emilio Soria, M.D.
• Danielle Soucie
• Source Direct Medical Supply, Inc
• Nicole South
• Khaila Southall
• Southlake Community Mental Health Center

• Pediatrics Physician in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.