NPIMap

Organization Active NPI

Lake County Jail

  • Public Health or Welfare Agency
  • Crown Point, IN
National Provider Identifier
1043626443
Registry record updated Jul 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
LAKE COUNTY JAIL
Practice address
2293 N Main St
Crown Point, IN 46307-1854
Phone
(219) 648-6300
Fax
(219) 755-3427
NPI assigned
Jul 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2014

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

Authorized official

Name
William Wallace Forgey, M.D.
Title
Medical Director
Phone
(219) 755-3385

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

2293 N Main St
Crown Point, IN 46307-1854

Mailing address

2293 N Main St
Crown Point, IN 46307-1854
Phone (219) 648-6300

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D1046945Lake County Jail2293 N Main St, Crown Point, IN 46307Certificate of waiverMay 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Lake County Governmenthealth Department2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2293 N Main St
Crown Point, IN 46307
Phone (219) 648-6300

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404691200000",
    "number": "1043626443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2293 N MAIN ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071854",
            "telephone_number": "219-648-6300",
            "fax_number": "219-755-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2293 N MAIN ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071854",
            "telephone_number": "219-648-6300",
            "fax_number": "219-755-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTY JAIL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-07",
        "last_updated": "2014-07-07",
        "status": "A",
        "authorized_official_last_name": "FORGEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "WALLACE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "219-755-3385",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.