Active NPI
John Sewell Gerometta, MD
- Anatomic Pathology & Clinical Pathology Physician
- Michigan City, IN
National Provider Identifier
1285627174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 01040073A
- Practice address
- 301 W Homer St
St Anthony Memorial Hospital
Michigan City, IN 46360-4358 - Phone
- (219) 861-8669
- Fax
- (219) 877-1081
- NPI assigned
- Aug 25, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 01040073A | IN | Primary |
Addresses
Primary practice location
301 W Homer St
St Anthony Memorial Hospital
Michigan City, IN 46360-4358
Mailing address
113 E 4TH St
Michigan City, IN 46360-3301
Phone (219) 879-2208
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2017120002 | Other | IN | CIGNA |
| 82425 | Other | IN | BC/BS |
| 5260529 | Other | IN | CCN |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01040073A | IN | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206662400000",
"number": "1285627174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 E 4TH ST",
"city": "MICHIGAN CITY",
"state": "IN",
"postal_code": "463603301",
"telephone_number": "219-879-2208",
"fax_number": "219-873-3131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 W HOMER ST",
"address_2": "ST ANTHONY MEMORIAL HOSPITAL",
"city": "MICHIGAN CITY",
"state": "IN",
"postal_code": "463604358",
"telephone_number": "219-861-8669",
"fax_number": "219-877-1081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEROMETTA",
"first_name": "JOHN",
"middle_name": "SEWELL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-25",
"last_updated": "2008-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "IN",
"license": "01040073A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2017120002",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "82425",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CCN",
"identifier": "5260529",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Michigan City, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.