Individual provider Active NPI

Mark Murdock, R. N..

  • Registered Nurse
  • Valparaiso, IN
National Provider Identifier
1275996928
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
28157795A Issued in IN
Practice address
1353 Sager Rd
37
Valparaiso, IN 46383-6454
Phone
(219) 405-6338
Fax
(866) 656-4532
NPI assigned
Mar 31, 2016
Last updated
Mar 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28157795A IN Primary
Registered Nurse 163W00000X 041337622 IL

Addresses

Primary practice location

1353 Sager Rd
37
Valparaiso, IN 46383-6454

Mailing address

PO Box 6
Valparaiso, IN 46384-0006
Phone (219) 405-6338

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041337622ILMDRegistered Nurse
28157795AINMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1275996928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463840006",
            "telephone_number": "219-405-6338",
            "fax_number": "866-656-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1353 SAGER RD",
            "address_2": "37",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463836454",
            "telephone_number": "219-405-6338",
            "fax_number": "866-656-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURDOCK",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "R. N..",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-31",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28157795A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041337622",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; 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.