NPIMap

Organization Active NPI

St Margaret Mercy Healthcare Centers Inc

Doing business as Omni Physician Suites

  • Family Medicine Physician
  • Schererville, IN
National Provider Identifier
1720157779
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 INC
Doing business as
Omni Physician Suites
Practice address
221 US Highway 41
Suite # 1
Schererville, IN 46375-1277
Phone
(219) 864-3950
Fax
(219) 864-3952
NPI assigned
Nov 6, 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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Adolescent Medicine (Family Medicine) Physician 207QA0000X
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

221 US Highway 41
Suite # 1
Schererville, IN 46375-1277

Mailing address

PO Box 1000
Dyer, IN 46311-0800
Phone (219) 864-2107

Other identifiers 2

IdentifierTypeStateIssuer
0090000854OtherILBCBS GROUP NUMBER
200159110RMedicaidIN

Other names 1

  • Omni Physician Suites Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262649600000",
    "number": "1720157779",
    "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": "219-864-2107",
            "fax_number": "219-864-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 US HIGHWAY 41",
            "address_2": "SUITE # 1",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463751277",
            "telephone_number": "219-864-3950",
            "fax_number": "219-864-3952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARGARET MERCY HEALTHCARE CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "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
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "0090000854",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200159110R",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omni Physician Suites",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Schererville, 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.