Grand Park Surgical Center, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

060062141 Issued in IN

Legal business name

GRAND PARK SURGICAL CENTER, INC

Practice address

1479 E 84TH PL
Merrillville, IN 46410-6451

Phone

(219) 738-2828

Fax

(219) 756-3349

NPI assigned

Dec 18, 2006

Last updated

Apr 28, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Lucy T Morales, R.N.

Title

C.E.O.

Phone

(219) 738-2828

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398643200000",
    "number": "1568525244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1479 E 84TH PL",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106451",
            "telephone_number": "219-738-2828",
            "fax_number": "219-756-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1479 E 84TH PL",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106451",
            "telephone_number": "219-738-2828",
            "fax_number": "219-756-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND PARK SURGICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2014-04-28",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "LUCY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "219-738-2828",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "IN",
            "license": "060062141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "000000098072",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100274590A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Graegin, PHARMD
• Kelley Grafton, MSN, RN
• Graham Pshchological Consulting and Restoration, Inc
• Darnika Candice Graham, M.D.
• Paris Graham
• Stephen Keith Grandfield, DPM
• Deborah Grandys, RD
• Natalie Martha Grantner, MSW
• Michelle Sue Graun, COTA
• Carol L Gray, COTA/L

• Federally Qualified Health Center (FQHC) in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Federally Qualified Health Center (FQHC) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.