NPIMap

Organization Active NPI

Michiana Hospitalist LLC

  • Internal Medicine Physician
  • Granger, IN
National Provider Identifier
1104985464
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MICHIANA HOSPITALIST LLC
Practice address
51265 Amesburry Way
Granger, IN 46530-4828
Phone
(574) 243-4875
Fax
(574) 243-4847
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Shamoon Ahmed, M.D.NPI 1831138072
Title
Medical Diretor
Phone
(574) 243-4875

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X IN Primary

Addresses

Primary practice location

51265 Amesburry Way
Granger, IN 46530-4828

Mailing address

51265 Amesburry Way
Granger, IN 46530-4828
Phone (574) 243-4875

Other names 1

  • Michiana hospitalist llc Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104985464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51265 AMESBURRY WAY",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465304828",
            "telephone_number": "574-243-4875",
            "fax_number": "574-243-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51265 AMESBURRY WAY",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465304828",
            "telephone_number": "574-243-4875",
            "fax_number": "574-243-4847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIANA HOSPITALIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "SHAMOON",
        "authorized_official_title_or_position": "MEDICAL DIRETOR",
        "authorized_official_telephone_number": "574-243-4875",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michiana hospitalist llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granger, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.