Active NPI
Sue E Mohlke, BSN, RN, CSA
- Surgical Assistant
- La Porte, IN
National Provider Identifier
1801938469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 2989
- Practice address
- 1300 State St Ste 2C
La Porte, IN 46350-3134 - Phone
- (219) 325-0152
- Fax
- (219) 325-8621
- NPI assigned
- Feb 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 28081333A | IN | |
| Surgical Assistant | 246ZC0007X | 2989 | IN | Primary |
Addresses
Primary practice location
1300 State St Ste 2C
La Porte, IN 46350-3134
Mailing address
1300 State St Ste 2C
La Porte, IN 46350-3134
Phone (219) 325-0152
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28081333A | IN | MD | Medical-Surgical Registered Nurse |
| 2989 | IN | MD | Surgical Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David S. Mendelowitz MD Surgery PC | Surgical Assistant | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228780800000",
"number": "1801938469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 STATE ST STE 2C",
"city": "LA PORTE",
"state": "IN",
"postal_code": "463503134",
"telephone_number": "219-325-0152",
"fax_number": "219-325-8621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 STATE ST STE 2C",
"city": "LA PORTE",
"state": "IN",
"postal_code": "463503134",
"telephone_number": "219-325-0152",
"fax_number": "219-325-8621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHLKE",
"first_name": "SUE",
"middle_name": "E",
"name_prefix": "Mrs.",
"credential": "BSN, RN, CSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-12",
"last_updated": "2008-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "IN",
"license": "28081333A",
"primary": false
},
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "IN",
"license": "2989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Porte, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.