Active NPI
Marquis Z Hodes, MD, PHD
- Pediatrics Physician
- West Lafayette, IN
National Provider Identifier
1588813844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01042224A
- Practice address
- 601 Stadium Mall Dr
West Lafayette, IN 47907-2052 - Phone
- (765) 494-1700
- Fax
- (765) 496-1227
- NPI assigned
- Sep 11, 2008
- Last updated
- Feb 2, 2011
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01042224A | IN | Primary |
Addresses
Primary practice location
601 Stadium Mall Dr
West Lafayette, IN 47907-2052
Mailing address
601 Stadium Mall Dr
West Lafayette, IN 47907-2052
Phone (765) 494-1700
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)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01042224A | IN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Past | Accepting new patients | |
| Madison County Community Health Centers Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296604800000",
"number": "1588813844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 STADIUM MALL DR",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479072052",
"telephone_number": "765-494-1700",
"fax_number": "765-496-1227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 STADIUM MALL DR",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479072052",
"telephone_number": "765-494-1700",
"fax_number": "765-496-1227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODES",
"first_name": "MARQUIS",
"middle_name": "Z",
"name_prefix": "Dr.",
"credential": "MD, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-11",
"last_updated": "2011-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01042224A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.