Four Seasons Medical Center, P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

01026202C Issued in IN

Legal business name

FOUR SEASONS MEDICAL CENTER, P.C.

Doing business as

Family Health and Wellness Centre, Ltd

Practice address

8683 Connecticut St
Suite B
Merrillville, IN 46410-6388

Phone

(219) 736-1022

Fax

(219) 769-7554

NPI assigned

Jan 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Stewart Brown III, M.D.

Title

President

Phone

(219) 736-1022

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Family Health and Wellness Centre, Ltd Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Julia Lynn Kocal, PSY.D.

  • Clinical Psychologist
  • Valparaiso, IN
  • NPI 1184818262
  NPD (past)
• Donald Pesavento, M.D.

  • Family Medicine Physician
  • Crown Point, IN
  • NPI 1104843937
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498176000000",
    "number": "1598817702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8683 CONNECTICUT ST",
            "address_2": "SUITE B",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106388",
            "telephone_number": "219-736-1022",
            "fax_number": "219-769-7554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8683 CONNECTICUT ST",
            "address_2": "SUITE B",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106388",
            "telephone_number": "219-736-1022",
            "fax_number": "219-769-7554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR SEASONS MEDICAL CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2017-06-23",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "STEWART",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-736-1022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IN",
            "license": "01026202C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000084541",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-ILLINOIS",
            "identifier": "91107784",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Health and Wellness Centre, Ltd",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charlotte Ford, MS
• Raven Ford
• Adrienne Foreman
• Forerunner Anesthesia LTD
• William Wallace Forgey, M.D.
• Angela Fowler
• Elizabeth Fox, RBT
• Lisa Fox
• Tammi Frailich, BA
• Michael Frampton, M.D.

• Primary Care Clinic/Center in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Primary Care Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2017; 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.