Organization Active NPI

Highland Clinic of Northwest Indiana Inc

  • General Practice Physician
  • Highland, IN
National Provider Identifier
1497954390
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
010226043 Issued in IN
Legal business name
HIGHLAND CLINIC OF NORTHWEST INDIANA INC
Practice address
2834 Highway Ave Ste 1
Highland, IN 46322
Phone
(219) 838-0066
Fax
(219) 838-4096
NPI assigned
Jul 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Authorized official

Name
Dr. Nazeerulla Shaik, M.D.
Title
Physician
Phone
(219) 838-0066

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 010226043 IN Primary

Addresses

Primary practice location

2834 Highway Ave Ste 1
Highland, IN 46322

Mailing address

2834 Highway Ave Ste 1
Highland, IN 46322-1629
Phone (219) 838-0066

Other practice location 1

2834 Highway Ave
Highland, IN 46322-1629
Phone (219) 838-0066

National Provider Directory

National Provider Directory

Locations

3801 Ridge Rd
Highland, IN 46322
Phone (219) 838-0066

Practitioners & affiliated clinicians

Practitioners 3

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": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544400000000",
    "number": "1497954390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2834 HIGHWAY AVE STE 1",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463221629",
            "telephone_number": "219-838-0066",
            "fax_number": "219-838-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2834 HIGHWAY AVE STE 1",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "46322",
            "telephone_number": "219-838-0066",
            "fax_number": "219-838-4096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2834 Highway Ave",
            "address_purpose": "LOCATION",
            "city": "Highland",
            "state": "IN",
            "postal_code": "463221629",
            "country_code": "US",
            "telephone_number": "219-838-0066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HIGHLAND CLINIC OF NORTHWEST INDIANA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2018-12-10",
        "status": "A",
        "authorized_official_last_name": "SHAIK",
        "authorized_official_first_name": "NAZEERULLA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "219-838-0066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "IN",
            "license": "010226043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.