NPIMap

Organization Active NPI

Midwest Mobile Medical Group PC

  • Podiatrist
  • Valparaiso, IN
National Provider Identifier
1831511336
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
07000937A Issued in IN
Legal business name
MIDWEST MOBILE MEDICAL GROUP PC
Practice address
2 Spectacle Dr
Valparaiso, IN 46383-1053
Phone
(219) 840-0345
NPI assigned
Jan 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Authorized official

Name
Jonathan Truchan, DPM
Title
Ceo/Medical Director
Phone
(219) 840-0345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 07000937A IN Primary

Addresses

Primary practice location

2 Spectacle Dr
Valparaiso, IN 46383-1053

Mailing address

2 Spectacle Dr
Valparaiso, IN 46383-1053

Other identifiers 1

IdentifierTypeStateIssuer
201213580AMedicaidIN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1389916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401235200000",
    "number": "1831511336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SPECTACLE DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463831053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SPECTACLE DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463831053",
            "telephone_number": "219-840-0345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST MOBILE MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-17",
        "last_updated": "2014-05-28",
        "status": "A",
        "authorized_official_last_name": "TRUCHAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CEO/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "219-840-0345",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07000937A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201213580A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; 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.