St Margaret Mercy Healthcare Centers, Inc

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

02000967A Issued in IN

Legal business name

ST MARGARET MERCY HEALTHCARE CENTERS, INC

Doing business as

Ear Nose and Throat Clinic

Practice address

24 Joliet St Ste 101
Dyer, IN 46311-1705

Phone

(219) 864-2059

Fax

(219) 864-2644

NPI assigned

Jan 6, 2010

Organization subpart

No

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

Authorized official

Name

Heather Maple

Title

Controller

Phone

(219) 932-2300

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ear Nose and Throat Clinic Doing business as

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262736000000",
    "number": "1669702106",
    "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": "219-864-2268",
            "fax_number": "219-864-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 JOLIET ST STE 101",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111705",
            "telephone_number": "219-864-2059",
            "fax_number": "219-864-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARGARET MERCY HEALTHCARE CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-06",
        "last_updated": "2010-01-06",
        "status": "A",
        "authorized_official_last_name": "MAPLE",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "219-932-2300"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "IN",
            "license": "02000967A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200504980",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ear Nose and Throat Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• St Margaret Mercy Healthcare Centers (Outpatient Behavioral Health Dyer)
• St Margaret Mercy Healthcare Centers (Specialty Health Center-Gynecologic Oncology)
• St Margaret Mercy Healthcare Centers (Dyer Family Practice)
• St Margaret Mercy Healthcare Centers Inc (Dyer Pediatric Services)
• St Margaret Mercy Healthcare Centers Inc (St Margaret Mercy Inpatient Specialist)
• St Margaret Mercy Healthcare Centers, Inc. (Dyer Childrens Services)
• St Margaret Mercy Healthcare Centers, Inc. (Fetal Medicine Clinic)
• St Margaret Mercy Healthcare Centers, Inc. (Physician Outpatient Clinic)
• St. Margaret Mercy Healthcare Centers Inc (St. Margaret Mercy Anesthesia Services)
• Sara Jinane Stafford, PT

• Otolaryngology/Facial Plastic Surgery Physician in Dyer, IN
• Providers in Dyer, IN by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.