NPIMap

Organization Active NPI

St Margaret Mercy Healthcare Centers

  • Pediatrics Physician
  • Munster, IN
National Provider Identifier
1376857516
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01024290A Issued in IN
Legal business name
ST MARGARET MERCY HEALTHCARE CENTERS
Practice address
8242 Calumet Ave
Munster, IN 46321-1758
Phone
(219) 836-5738
Fax
(219) 836-5782
NPI assigned
Jul 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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

Authorized official

Name
Thomas Gryzbek
Title
President
Phone
(219) 932-2300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 01024290A IN Primary

Addresses

Primary practice location

8242 Calumet Ave
Munster, IN 46321-1758

Mailing address

PO Box 1000
Dyer, IN 46311-0800
Phone (219) 864-2297

Other identifiers 1

IdentifierTypeStateIssuer
200504980MedicaidIN

Other names 1

  • Munster Medical Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dyer Family Practice17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282089600000",
    "number": "1376857516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463110800",
            "telephone_number": "219-864-2297",
            "fax_number": "219-864-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8242 CALUMET AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211758",
            "telephone_number": "219-836-5738",
            "fax_number": "219-836-5782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARGARET MERCY HEALTHCARE CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-29",
        "last_updated": "2010-08-18",
        "status": "A",
        "authorized_official_last_name": "GRYZBEK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-932-2300"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01024290A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200504980",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Munster Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Munster, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; 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.