Active NPI
Mark Murdock, R. N..
- Registered Nurse
- Valparaiso, IN
National Provider Identifier
1275996928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 28157795A
- 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, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 041337622 | IL | MD | Registered Nurse |
| 28157795A | IN | MD | Registered 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.