Organization Active NPI

Nathaniel Ross MD

  • Family Medicine Physician
  • Merrillville, IN
National Provider Identifier
1396754073
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01052287 Issued in IN
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, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

NPI 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": []
}

Other providers in Merrillville, IN

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.

Verify at the official NPI Registry.