Active NPI
Keith Wygle, LCSW
- Clinical Social Worker
- Hammond, IN
National Provider Identifier
1528296993
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Sep 19, 2024.
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34005872A
- Practice address
- 5900 Hohman Ave
Hammond, IN 46320-2423 - Phone
- (219) 931-0427
- Fax
- (219) 931-0427
- NPI assigned
- Jun 24, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34005872A | IN | Primary |
Addresses
Primary practice location
5900 Hohman Ave
Hammond, IN 46320-2423
Mailing address
8400 Louisiana St
Merrillville, IN 46410-6385
Phone (219) 757-1928
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34005872A | IN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306281600000",
"number": "1528296993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8400 LOUISIANA ST",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "464106385",
"telephone_number": "219-757-1928",
"fax_number": "219-757-1950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 HOHMAN AVE",
"city": "HAMMOND",
"state": "IN",
"postal_code": "463202423",
"telephone_number": "219-931-0427",
"fax_number": "219-931-0427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYGLE",
"first_name": "KEITH",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-24",
"last_updated": "2011-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34005872A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hammond, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.