NPIMap

Organization Active NPI

Weldon Cooke MD LLC

  • Primary Care Clinic/Center
  • Michigan City, IN
National Provider Identifier
1528466091
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
01020627A Issued in IN
Legal business name
WELDON COOKE MD LLC
Practice address
10176 W 400 N
Suite C
Michigan City, IN 46360-9008
Phone
(219) 873-1777
Fax
(219) 873-0001
NPI assigned
Dec 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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

Authorized official

Name
Tina J Bowmar
Title
Admin
Phone
(219) 221-7287

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 01020627A IN Primary

Addresses

Primary practice location

10176 W 400 N
Suite C
Michigan City, IN 46360-9008

Mailing address

10176 W 400 N
Suite C
Michigan City, IN 46360-9008
Phone (219) 873-1777

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418601600000",
    "number": "1528466091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10176 W 400 N",
            "address_2": "SUITE C",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463609008",
            "telephone_number": "219-873-1777",
            "fax_number": "219-873-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10176 W 400 N",
            "address_2": "SUITE C",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463609008",
            "telephone_number": "219-873-1777",
            "fax_number": "219-873-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELDON COOKE MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-15",
        "last_updated": "2014-12-15",
        "status": "A",
        "authorized_official_last_name": "BOWMAR",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "219-221-7287"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IN",
            "license": "01020627A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; 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.