Forerunner Anesthesia LTD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

FORERUNNER ANESTHESIA LTD

Practice address

8900 Broadway
Suite 100W
Merrillville, IN 46410-7040

Phone

(847) 309-9896

NPI assigned

May 27, 2013

Last updated

May 28, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Aristeidie M Diveris, MD

Title

President

Phone

(847) 309-9896

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1369612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369699200000",
    "number": "1316384795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N SHERIDAN RD",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600452226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 BROADWAY",
            "address_2": "SUITE 100W",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107040",
            "telephone_number": "847-309-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORERUNNER ANESTHESIA LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-27",
        "last_updated": "2013-05-28",
        "status": "A",
        "authorized_official_last_name": "DIVERIS",
        "authorized_official_first_name": "ARISTEIDIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-309-9896",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• For the Culture Therapy
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• Charlotte Ford, MS
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• William Wallace Forgey, M.D.
• Four Seasons Medical Center, P.C. (Family Health and Wellness Centre, Ltd)
• Angela Fowler
• Elizabeth Fox, RBT
• Lisa Fox

• Anesthesiology Physician in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Anesthesiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2013; 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.