Individual provider Active NPI

Anthony Mario Romeo, APRN

  • Adult Health Clinical Nurse Specialist
  • Munster, IN
National Provider Identifier
1801943865
Registry record updated Oct 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
71009526A Issued in IN
Practice address
9800 Valparaiso Dr
Munster, IN 46321
Phone
(219) 934-9800
Fax
(219) 924-8831
NPI assigned
Jan 4, 2007
Last updated
Oct 27, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 71009526A IN Primary
Registered Nurse First Assistant 163WR0006X 28159760A IN
Registered Nurse First Assistant 163WR0006X 041229107 IL

Addresses

Primary practice location

9800 Valparaiso Dr
Munster, IN 46321

Mailing address

1040 Sierra Dr Ste 400
Greenwood, IN 46143-7241
Phone (317) 528-4800

Other practice location 1

14937 Cog Hill Ln
Homer Glen, IL 60491-5930
Phone (708) 705-5462

Other practice location 2

9800 Valparaiso Dr
Munster, IN 46321
Phone (219) 934-9800

Other identifiers 1

IdentifierTypeStateIssuer
300010783MedicaidIN

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
041229107ILMDRegistered Nurse First Assistant
71009526AINMDAdult Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572134400000",
    "number": "1801943865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 SIERRA DR STE 400",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461437241",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 VALPARAISO DR",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "46321",
            "telephone_number": "219-934-9800",
            "fax_number": "219-924-8831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14937 Cog Hill Ln",
            "address_purpose": "LOCATION",
            "city": "Homer Glen",
            "state": "IL",
            "postal_code": "604915930",
            "country_code": "US",
            "telephone_number": "708-705-5462",
            "fax_number": "708-229-4959",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9800 Valparaiso Dr",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "46321",
            "country_code": "US",
            "telephone_number": "219-934-9800",
            "fax_number": "219-924-8831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMEO",
        "first_name": "ANTHONY",
        "middle_name": "MARIO",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2019-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "IN",
            "license": "71009526A",
            "primary": true
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "IN",
            "license": "28159760A",
            "primary": false
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "IL",
            "license": "041229107",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300010783",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2019; 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.