NPIMap

Organization Active NPI

Surgical Services of Northern Indiana, LLC

  • Surgical Physician Assistant
  • Granger, IN
National Provider Identifier
1699729111
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1000226A Issued in IN
Legal business name
SURGICAL SERVICES OF NORTHERN INDIANA, LLC
Practice address
50744 Pheasant Cove Dr
Granger, IN 46530-8835
Phone
(574) 261-9444
Fax
(574) 272-2220
NPI assigned
May 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Timothy Barnard, PA-CNPI 1427044056
Title
President
Phone
(574) 261-9444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X 1000226A IN Primary

Addresses

Primary practice location

50744 Pheasant Cove Dr
Granger, IN 46530-8835

Mailing address

50744 Pheasant Cove Dr
Granger, IN 46530-8835
Phone (574) 273-1232

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699729111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50744 PHEASANT COVE DR",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465308835",
            "telephone_number": "574-273-1232",
            "fax_number": "574-272-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50744 PHEASANT COVE DR",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465308835",
            "telephone_number": "574-261-9444",
            "fax_number": "574-272-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL SERVICES OF NORTHERN INDIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARNARD",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-261-9444",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "1000226A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granger, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.