Active NPI
Nathaniel Ross MD
- Family Medicine Physician
- Merrillville, IN
National Provider Identifier
1396754073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01052287
- Legal business name
- NATHANIEL ROSS MD
- Practice address
- 8701 Broadway
Merrillville, IN 46410-7035 - Phone
- (219) 769-1670
- Fax
- (219) 738-6714
- NPI assigned
- Aug 5, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nathaniel Ross, MD
- Title
- Physician/Owner
- Phone
- (219) 769-1670
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01052287 | IN | Primary |
Addresses
Primary practice location
8701 Broadway
Merrillville, IN 46410-7035
Mailing address
55 E 86TH Ave
PO Box 10645
Merrillville, IN 46410-6382
Phone (219) 769-1670
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1396754073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 E 86TH AVE",
"address_2": "PO BOX 10645",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "464106382",
"telephone_number": "219-769-1670",
"fax_number": "219-738-6714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8701 BROADWAY",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "464107035",
"telephone_number": "219-769-1670",
"fax_number": "219-738-6714"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NATHANIEL ROSS MD",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-05",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "ROSS",
"authorized_official_first_name": "NATHANIEL",
"authorized_official_title_or_position": "PHYSICIAN/OWNER",
"authorized_official_telephone_number": "219-769-1670",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "IN",
"license": "01052287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.