NPIMap

Organization Active NPI

Laporte Regional Physician Netork

Doing business as Johnson Road Internal Medicine

  • Internal Medicine Physician
  • La Porte, IN
National Provider Identifier
1578674495
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LAPORTE REGIONAL PHYSICIAN NETORK
Doing business as
Johnson Road Internal Medicine
Practice address
7002 W Johnson Rd
La Porte, IN 46350-8289
Phone
(219) 325-0604
Fax
(219) 879-1401
NPI assigned
Aug 31, 2006
Last updated
Jun 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Authorized official

Name
Rhonda Volk
Title
Executive Director
Phone
(219) 326-2485

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

7002 W Johnson Rd
La Porte, IN 46350-8289

Mailing address

PO Box 1690
La Porte, IN 46352-1690
Phone (219) 326-2312

Other identifiers 1

IdentifierTypeStateIssuer
100165070BMedicaidIN

Other names 1

  • Johnson Road Internal Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lakeland Psychiatric SV28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1578674495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1690",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463521690",
            "telephone_number": "219-326-2312",
            "fax_number": "219-326-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7002 W JOHNSON RD",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463508289",
            "telephone_number": "219-325-0604",
            "fax_number": "219-879-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAPORTE REGIONAL PHYSICIAN NETORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "VOLK",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "219-326-2485"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100165070B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johnson Road Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Porte, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.