NPIMap

Organization Active NPI

Indiana Breast Center

Doing business as Ludag LLC

  • Diagnostic Radiology Physician
  • Crown Point, IN
National Provider Identifier
1174787204
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
INDIANA BREAST CENTER
Doing business as
Ludag LLC
Practice address
5363 Commerce Dr
Crown Point, IN 46307-5325
Phone
(219) 769-5000
NPI assigned
Jul 17, 2008
Organization subpart
Yes
Parent organization
LUDAG LLC DBA CANCER TREATMENT GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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

Authorized official

Name
Robert T Woodburn III, MDNPI 1407848849
Title
President
Phone
(574) 271-2558

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
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

5363 Commerce Dr
Crown Point, IN 46307-5325

Mailing address

5363 Commerce Dr
Crown Point, IN 46307-5325
Phone (219) 769-5000

Other identifiers 1

IdentifierTypeStateIssuer
200397270MedicaidIN

Other names 1

  • Ludag LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Indiana Breast Center6 organizations share this tax ID, including this one
Part of
Indiana Breast Center

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1216252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1174787204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5363 COMMERCE DR",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463075325",
            "telephone_number": "219-769-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5363 COMMERCE DR",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463075325",
            "telephone_number": "219-769-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA BREAST CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUDAG LLC DBA CANCER TREATMENT GROUP",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "WOODBURN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-271-2558",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200397270",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ludag LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.