NPIMap

Organization Active NPI

Michigan City Radiologists, Inc

  • Diagnostic Radiology Physician
  • Michigan City, IN
National Provider Identifier
1366492936
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
50000203A Issued in IN
Legal business name
MICHIGAN CITY RADIOLOGISTS, INC
Practice address
301 W Homer St
Michigan City, IN 46360-4358
Phone
(219) 872-7464
Fax
(219) 877-1066
NPI assigned
May 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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

Authorized official

Name
Jill Johnson
Title
Administrator
Phone
(219) 872-7464

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 50000203A IN Primary

Addresses

Primary practice location

301 W Homer St
Michigan City, IN 46360-4358

Mailing address

PO Box 2010
Michigan City, IN 46361-8010
Phone (219) 872-7464

National Provider Directory

National Provider Directory

Locations

8865 W 400 N
#115
Michigan City, IN 46360
Phone (219) 842-7268

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315267200000",
    "number": "1366492936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2010",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463618010",
            "telephone_number": "219-872-7464",
            "fax_number": "219-877-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W HOMER ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463604358",
            "telephone_number": "219-872-7464",
            "fax_number": "219-877-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN CITY RADIOLOGISTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2011-09-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "219-872-7464"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "50000203A",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 6, 2011; 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.