NPIMap

Organization Active NPI

St Margaret Mercy Healthcare Centers, Inc.

Doing business as East Chicago Family Services

  • Internal Medicine Physician
  • East Chicago, IN
National Provider Identifier
1801975438
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ST MARGARET MERCY HEALTHCARE CENTERS, INC.
Doing business as
East Chicago Family Services
Practice address
2001 E Columbus Dr
Suite # C
East Chicago, IN 46312-2829
Phone
(219) 933-2623
Fax
(219) 378-9283
NPI assigned
Nov 3, 2006
Last updated
Jun 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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 2

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

Addresses

Primary practice location

2001 E Columbus Dr
Suite # C
East Chicago, IN 46312-2829

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
200159110JMedicaidIN
0090000854OtherILBCBS GROUP NUMBER

Other names 1

  • East Chicago Family Services Doing business as

National Provider Directory

National Provider Directory

Locations

2001 E Columbus Dr
Ste C
East Chicago, IN 46312
Phone (219) 933-2623

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1801975438",
    "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": "2001 E COLUMBUS DR",
            "address_2": "SUITE # C",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463122829",
            "telephone_number": "219-933-2623",
            "fax_number": "219-378-9283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARGARET MERCY HEALTHCARE CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2008-06-23",
        "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": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200159110J",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "0090000854",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Chicago Family Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Chicago, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.

Verify at the official NPI Registry.