Organization Active NPI

Porter-Starke Services Inc.

  • Federally Qualified Health Center (FQHC)
  • Gary, IN
National Provider Identifier
1194473595
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PORTER-STARKE SERVICES INC.
Practice address
3229 Broadway Ste 104
Gary, IN 46409-1041
Phone
(219) 806-3000
NPI assigned
Mar 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Authorized official

Name
Kate Sanders
Title
VP Systems Administration
Phone
(219) 476-4664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

3229 Broadway Ste 104
Gary, IN 46409-1041

Mailing address

601 Wall St
Valparaiso, IN 46383-2512
Phone (219) 806-3000

Other names 1

  • MARRAM HEALTH CENTER SUITE 104 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040330000098 IN Part B Supplier - Clinic/Group Practice 1951293554 Receives reassigned benefits from 108 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Valparaiso, IN; Portage, IN; Knox, IN; Gary, IN; Hebron, IN
O20220729001598 IN Part A Provider - Federally Qualified Health Center (FQHC) 1951293554 Practice locations: Gary, IN

Federally qualified health center certification: CCN 151143

Legal name
PORTER-STARKE SERVICES INC
Doing business as
MARRAM HEALTH CENTER SUITE 104
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 19, 2022
Last certification
Jul 19, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
3229 Broadway
Ste 104
Gary, IN 46409-1041

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Porter-Starke Services Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Clarence Boykin Individual Corporate OfficerVP, Marram Health Services Jan 1, 2022
Operational/Managerial ControlVP, Marram Health Services Jan 1, 2022
Andrew Nielsen Individual Corporate OfficerChief Financial Officer Jan 1, 2022
W-2 Managing EmployeeChief Financial Officer Jan 1, 2022
Lisa Scheller Individual Corporate DirectorBoard Member Mar 24, 2026
Vanessa Allen-McCloud Individual Corporate DirectorBoard Member Jan 28, 2025
Mary Elizabeth Kominiak Individual Corporate DirectorBoard Member Jan 28, 2025
Robert Bryant Individual Corporate DirectorBoard Member Jan 28, 2025
Otto Shragal Individual Corporate DirectorBoard Member Mar 24, 2026
Andrew Zromkoski Individual Corporate DirectorBoard Member Jan 28, 2025
Mark Goodrich Individual Corporate OfficerVP, Human Resources Jan 1, 2022
W-2 Managing EmployeeVP, Human Resources Jan 1, 2022
Operational/Managerial ControlVP, Human Resources Jan 1, 2022
Kate Sanders Individual Corporate OfficerVP Systems Administration Jun 1, 2022
W-2 Managing EmployeeVP Systems Administration Jun 1, 2022
Chad Nally Individual Corporate DirectorBoard Member Jan 28, 2025
Sharron Liggins Individual Corporate DirectorBoard Member Jan 28, 2025
Judith Jelinek Individual Corporate DirectorBoard Member Jan 28, 2025
Sandra Ruth Carlson Individual Corporate OfficerVP, Clinical Services Jan 1, 2022
W-2 Managing EmployeeVP, Clinical Services Jan 2, 2022
Operational/Managerial ControlVP, Clinical Services Jan 1, 2022
Susan Kelly-Johnson Individual Corporate DirectorBoard Member Jan 28, 2025
Irene Szakonyi Individual Corporate DirectorBoard Member Sep 2, 2025
Michael Weaver Individual Corporate OfficerCeo Jan 2, 2021
W-2 Managing EmployeeCeo Jan 2, 2021
Operational/Managerial Control Jan 2, 2021
Matthew Burden Individual Corporate OfficerPresident/Ceo Jan 1, 2022
W-2 Managing EmployeePresident/Ceo Jan 1, 2022
Operational/Managerial ControlPresident/Ceo Jan 1, 2022

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Porter Starke Services IncValparaiso, IN, CCN 154052 Hospital Operational/Managerial Control
Other
Jul 24, 1967
Jul 24, 1967
Marram Health CenterGary, IN, CCN 151956 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 27, 2015
Marram Health CenterHebron, IN, CCN 151051 Federally qualified health center 5% Or Greater Direct Ownership Interest Jul 24, 1967

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1194473595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 WALL ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832512",
            "telephone_number": "219-806-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3229 BROADWAY STE 104",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464091041",
            "telephone_number": "219-806-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTER-STARKE SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "KATE",
        "authorized_official_title_or_position": "VP SYSTEMS ADMINISTRATION",
        "authorized_official_telephone_number": "219-476-4664"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARRAM HEALTH CENTER SUITE 104",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gary, IN

Sources for this page

Verify at the official NPI Registry.