Indiana Regional Sleep Disorders Center, Inc

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

01064140 Issued in IN

Legal business name

INDIANA REGIONAL SLEEP DISORDERS CENTER, INC

Practice address

2269 W 25TH Ave
Gary, IN 46404-3367

Phone

(219) 944-4187

Fax

(219) 944-4196

NPI assigned

Nov 15, 2007

Organization subpart

No

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

Authorized official

Name

Olusegun Apata, MD

Title

Physician/Owner

Phone

(219) 882-0255

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266537600000",
    "number": "1215118559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10160",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464110160",
            "telephone_number": "219-944-4187",
            "fax_number": "219-738-6714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2269 W 25TH AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464043367",
            "telephone_number": "219-944-4187",
            "fax_number": "219-944-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA REGIONAL SLEEP DISORDERS CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2010-02-19",
        "status": "A",
        "authorized_official_last_name": "APATA",
        "authorized_official_first_name": "OLUSEGUN",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "219-882-0255",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01064140",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01064140",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "IN",
            "license": "01064140",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200876330",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.