CBC, L.L.C.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

080107642 Issued in IN

Legal business name

CBC, L.L.C.

Practice address

5355 Commerce Boulevard
Crown Point, IN 46307-5325

Phone

(219) 756-0600

Fax

(219) 756-0608

NPI assigned

Mar 4, 2008

Last updated

Sep 10, 2018By 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

Jeffrey Yessenow, MD

Title

Co-President

Phone

(219) 756-0600

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2458/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/989/brand/2/csg/42/fhir/r4

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536537600000",
    "number": "1336319649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5355 COMMERCE BOULEVARD",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463075325",
            "telephone_number": "219-756-0600",
            "fax_number": "219-756-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5355 COMMERCE BOULEVARD",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463075325",
            "telephone_number": "219-756-0600",
            "fax_number": "219-756-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CBC, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2018-09-10",
        "status": "A",
        "authorized_official_last_name": "YESSENOW",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CO-PRESIDENT",
        "authorized_official_telephone_number": "219-756-0600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IN",
            "license": "080107642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000566567",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Ambulatory Surgical Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.