Active NPI
Stephanie Jahoda
- Community Health Registered Nurse
- Gary, IN
National Provider Identifier
1114734431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Registered Nurse
- License
- 28216777A
- Practice address
- 1021 W 5TH Ave
Gary, IN 46402-1703 - Phone
- (219) 880-1190
- NPI assigned
- Dec 11, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Registered Nurse | 163WC1500X | 28216777A | IN | Primary |
Addresses
Primary practice location
1021 W 5TH Ave
Gary, IN 46402-1703
Mailing address
6167 Brie Ave
Portage, IN 46368-3654
Phone (219) 973-9421
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28216777A | IN | MD | Community Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733875200000",
"number": "1114734431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6167 BRIE AVE",
"city": "PORTAGE",
"state": "IN",
"postal_code": "463683654",
"telephone_number": "219-973-9421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1021 W 5TH AVE",
"city": "GARY",
"state": "IN",
"postal_code": "464021703",
"telephone_number": "219-880-1190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAHODA",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-11",
"last_updated": "2024-12-11",
"certification_date": "2024-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "163WC1500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Community Health",
"state": "IN",
"license": "28216777A",
"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 Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.