SRD Podiatry P.C.

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

07000980A Issued in IN

Legal business name

SRD PODIATRY P.C.

Practice address

1237 W. 82ND Lane
Merrillville, IN 46410

Phone

(219) 791-0667

Fax

(219) 791-0657

NPI assigned

Jun 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Sherese R Dillon, DPMNPI 1598730020

Title

Ceo

Phone

(219) 791-0667

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 1

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

• Sherese R Dillon, DPM

  • Podiatrist
  • Merrillville, IN
  • NPI 1598730020

  Primary Podiatric Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376749168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 W. 82ND PL",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "46410",
            "telephone_number": "219-791-0667",
            "fax_number": "219-791-0657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 W. 82ND LANE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "46410",
            "telephone_number": "219-791-0667",
            "fax_number": "219-791-0657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRD PODIATRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DILLON",
        "authorized_official_first_name": "SHERESE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "219-791-0667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "IN",
            "license": "07000980A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jorie April Spinks, MSW, LSW
• Raylene Spisak
• Jamie Sponaugle, BS
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• Natalie Spychala
• Anekal B Sreeram, MD
• St. John Therapy Services, Inc.
• St. Mary Medical Center
• St. Mary Medical Center Inc (Michael Kovacich MD)
• Sabrina Stackhouse, MT

• Primary Podiatric Medicine Podiatrist in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Primary Podiatric Medicine Podiatrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.