NPIMap

Organization Active NPI

Heartlandmemorial Hospital, LLC.

  • Family Medicine Physician
  • Munster, IN
National Provider Identifier
1801956586
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HEARTLANDMEMORIAL HOSPITAL, LLC.
Practice address
701 Superior Ave
Suite C
Munster, IN 46321-4037
Phone
(219) 934-4049
Fax
(219) 934-4060
NPI assigned
Dec 11, 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
Dr. Jeffrey Yessenow, M.D.
Title
Ceo
Phone
(219) 922-4200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

701 Superior Ave
Suite C
Munster, IN 46321-4037

Mailing address

P.O. Box 3516
Munster, IN 46321-4037
Phone (219) 934-4049

National Provider Directory

National Provider Directory
Tax ID family
Heartland Memorial Hospital LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

701 Superior Ave
Ste C
Munster, IN 46321
Phone (219) 934-4049

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801956586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3516",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214037",
            "telephone_number": "219-934-4049",
            "fax_number": "219-934-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SUPERIOR AVE",
            "address_2": "SUITE C",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214037",
            "telephone_number": "219-934-4049",
            "fax_number": "219-934-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLANDMEMORIAL HOSPITAL, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YESSENOW",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "219-922-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 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.