Individual provider Active NPI

Tanya Marie Gorgas

  • Licensed Practical Nurse
  • Gary, IN
National Provider Identifier
1104319052
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
27056484A Issued in IN
Practice address
1100 W 6TH Ave
Gary, IN 46402-1711
Phone
(219) 885-4264
Fax
(219) 239-2944
NPI assigned
Jun 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Medical Examiner Physician 202C00000X 27056484A IN
Licensed Practical Nurse 164W00000X 27056484A IN Primary

Addresses

Primary practice location

1100 W 6TH Ave
Gary, IN 46402-1711

Mailing address

1100 W 6TH Ave
Gary, IN 46402-1711
Phone (219) 885-4264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27056484AINMDIndependent Medical Examiner Physician

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1104319052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W 6TH AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464021711",
            "telephone_number": "219-885-4264",
            "fax_number": "219-239-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W 6TH AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464021711",
            "telephone_number": "219-885-4264",
            "fax_number": "219-239-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORGAS",
        "first_name": "TANYA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202C00000X",
            "taxonomy_group": "",
            "desc": "Independent Medical Examiner",
            "state": "IN",
            "license": "27056484A",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IN",
            "license": "27056484A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gary, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.