Chest Clinic, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

50003970A Issued in IN

Legal business name

CHEST CLINIC, PC

Practice address

10176 W 400 N
Suite B
Michigan City, IN 46360-9008

Phone

(219) 878-5864

Fax

(219) 878-0632

NPI assigned

Oct 18, 2006

Last updated

Apr 28, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Siraj K Ahmed, M.D.

Title

Physician/President

Phone

(219) 878-5864

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

Practitioners 1

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.

• Rose Marie Flinchum, CNS, RN

  • Adult Health Clinical Nurse Specialist
  • La Porte, IN
  • NPI 1093121063
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240876800000",
    "number": "1053492926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10176 W 400 N",
            "address_2": "SUITE B",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463609008",
            "telephone_number": "219-878-5864",
            "fax_number": "219-878-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10176 W 400 N",
            "address_2": "SUITE B",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463609008",
            "telephone_number": "219-878-5864",
            "fax_number": "219-878-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEST CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2009-04-28",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "SIRAJ",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "219-878-5864",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "50003970A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200903550B",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200903550C",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100165460A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200903550 A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GROUP PROVIDER NUM",
            "identifier": "000000104803",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anil Chawla, MD
• Sang Young Chyung, M.D.
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• Beverly Clancy
• Elizabeth Clements
• Seth Jeremy Clifford, DO

• Internal Medicine Physician in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; 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.