NPIMap

Organization Active NPI

St Margaret Mercy Healthcare Centers

Doing business as St John Family Services

  • Family Medicine Physician
  • Saint John, IN
National Provider Identifier
1659448314
Registry record updated Jan 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST MARGARET MERCY HEALTHCARE CENTERS
Doing business as
St John Family Services
Practice address
10860 Maple LN
Saint John, IN 46373-8418
Phone
(219) 365-7000
Fax
(219) 365-2609
NPI assigned
Nov 29, 2006
Last updated
Jan 5, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2010

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

Authorized official

Name
Thomas Gryzbek
Title
President
Phone
(219) 932-2300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

10860 Maple LN
Saint John, IN 46373-8418

Mailing address

PO Box 1000
Dyer, IN 46311-0800
Phone (219) 365-7000

Other identifiers 2

IdentifierTypeStateIssuer
0090000854OtherILBCBS GROUP NUMBER
200159110YMedicaidIN

Other names 1

  • St John Family Services Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262649600000",
    "number": "1659448314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463110800",
            "telephone_number": "219-365-7000",
            "fax_number": "219-365-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10860 MAPLE LN",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463738418",
            "telephone_number": "219-365-7000",
            "fax_number": "219-365-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARGARET MERCY HEALTHCARE CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2010-01-05",
        "status": "A",
        "authorized_official_last_name": "GRYZBEK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-932-2300"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "0090000854",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200159110Y",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St John Family Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint John, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; 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.