Individual provider Active NPI

Lucille Ann Newton

  • Developmental Therapist
  • Chesterton, IN
National Provider Identifier
1184285835
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
1595 S Calumet Rd Ste 3
Chesterton, IN 46304-2389
Phone
(219) 764-4888
Fax
(219) 898-4258
NPI assigned
Jun 24, 2019
Reactivated
Jun 17, 2020
Last updated
Jun 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X NU Primary
Behavior Technician 106S00000X NU

Addresses

Primary practice location

1595 S Calumet Rd Ste 3
Chesterton, IN 46304-2389

Mailing address

PO Box 283
Brooklyn, IN 46111
Phone (317) 910-5118

Other practice location 1

1595 S Calumet Rd
Suite 3
Chesterton, IN 46304
Phone (219) 764-4888

Other identifiers 1

IdentifierTypeStateIssuer
200196020AMedicaidIN

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jacob's Ladder Pediatric Rehab Center CurrentSince Aug 4, 2024 Accepting new patients
Jacob's Ladder Pediatric Rehab Center CurrentSince Aug 11, 2024 Accepting new patients
Innovations in Learning, PC Behavior Technician PastSince Nov 30, 2006 Accepting new patients

Locations

1595 S Calumet Rd
Ste 3
Chesterton, IN 46304
Phone (219) 250-3202

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1184285835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 283",
            "city": "BROOKLYN",
            "state": "IN",
            "postal_code": "46111",
            "telephone_number": "317-910-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 S CALUMET RD STE 3",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463042389",
            "telephone_number": "219-764-4888",
            "fax_number": "219-898-4258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1595 S Calumet Rd",
            "address_2": "Suite 3",
            "address_purpose": "LOCATION",
            "city": "Chesterton",
            "state": "IN",
            "postal_code": "46304",
            "country_code": "US",
            "telephone_number": "219-764-4888",
            "fax_number": "219-898-4258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWTON",
        "first_name": "LUCILLE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "deactivation_date": "2020-06-09",
        "reactivation_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200196020A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterton, IN

Sources for this page

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