BKRD, Inc

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

01065198A Issued in IN

Legal business name

BKRD, INC

Practice address

302 Garden TRL
Michigan City, IN 46360-2710

Phone

(219) 561-6303

NPI assigned

Sep 25, 2015

Last updated

Sep 25, 2015By 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

Brandi Kathryn Ross-Douglas, M.D.

Title

President

Phone

(219) 561-6303

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443139200000",
    "number": "1649640202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 GARDEN TRL",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463602710",
            "telephone_number": "219-561-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 GARDEN TRL",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463602710",
            "telephone_number": "219-561-6303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BKRD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-25",
        "last_updated": "2015-09-25",
        "status": "A",
        "authorized_official_last_name": "ROSS-DOUGLAS",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_middle_name": "KATHRYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-561-6303",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01065198A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Critical Care Medicine (Internal Medicine) Physician in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Critical Care Medicine (Internal Medicine) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; 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.