Lifecare of Indiana LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LIFECARE OF INDIANA LLC

Practice address

240 Commerce SQ
Michigan City, IN 46360-3282

Phone

(219) 324-5005

NPI assigned

Jun 23, 2021

Organization subpart

No

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

Authorized official

Name

Isaac J Leestma

Title

Coo / Administrator

Phone

(616) 821-3485

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

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

• Patricia A Wangerin, NP

  • Nurse Practitioner
  • Munster, IN
  • NPI 1962442483
  NPD

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658448000000",
    "number": "1639748692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 COMMERCE SQ",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463603282",
            "telephone_number": "231-299-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 COMMERCE SQ",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463603282",
            "telephone_number": "219-324-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECARE OF INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A",
        "authorized_official_last_name": "LEESTMA",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COO / ADMINISTRATOR",
        "authorized_official_telephone_number": "616-821-3485"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Leonard, PT
• Stacey Colleen Leva, DO
• Joshua Tyler Lewis, PHARMD
• Katie Louise Lewis, PHARMD
• Lifecare of Indiana Inc
• Lily Lin
• Lisa Leniski, DDS, MSD, LLC
• Jason C Little, NP
• Brenda Marie Loggins
• Karen Lynn Lopez, CNA, MA

• Family Medicine Physician in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.