NPIMap

Organization Active NPI

Lake Urology, LLC

  • Urology Physician
  • Merrillville, IN
National Provider Identifier
1144532656
Registry record updated Jul 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
01036410A Issued in IN
Legal business name
LAKE UROLOGY, LLC
Practice address
8558 Broadway
Merrillville, IN 46410-7032
Phone
(219) 736-0616
NPI assigned
Jul 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2010

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

Authorized official

Name
Vicki Orr
Title
Biller
Phone
(219) 836-6241

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X 01036410A IN Primary

Addresses

Primary practice location

8558 Broadway
Merrillville, IN 46410-7032

Mailing address

PO Box 3060
Munster, IN 46321-0060
Phone (219) 836-6241

National Provider Directory

National Provider Directory

Locations

8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084

Practitioners & affiliated clinicians

Practitioners 1

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": "1278979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278979200000",
    "number": "1144532656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3060",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463210060",
            "telephone_number": "219-836-6241",
            "fax_number": "219-836-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8558 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107032",
            "telephone_number": "219-736-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE UROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-13",
        "last_updated": "2010-07-13",
        "status": "A",
        "authorized_official_last_name": "ORR",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "219-836-6241"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "IN",
            "license": "01036410A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; 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.