Northwest Indiana Medical Consultants PC

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

01046988 Issued in IN

Legal business name

NORTHWEST INDIANA MEDICAL CONSULTANTS PC

Practice address

5304 Broadway
Merrillville, IN 46410-1555

Phone

(219) 985-2510

Fax

(219) 985-2532

NPI assigned

Jan 23, 2007

Last updated

Jun 25, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Josette Cherie Jackson

Title

Office Manager

Phone

(219) 985-2510

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1841344165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5304 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464101555",
            "telephone_number": "219-985-2510",
            "fax_number": "219-985-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5304 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464101555",
            "telephone_number": "219-985-2510",
            "fax_number": "219-985-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST INDIANA MEDICAL CONSULTANTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JOSETTE",
        "authorized_official_middle_name": "CHERIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "219-985-2510"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "IN",
            "license": "01046988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200148340B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northwest Ambulance Services Inc
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• Northwest Indiana Heart Center, P.C.
• Northwest Indiana Meals on Wheels Inc.
• Northwest Indiana Occupational Pain and Wellness Center, LLC
• Northwest Indiana Podiatry Clinic, LLC
• Northwest Indiana Retina Institute LLC
• Northwest Indiana Spinal Surgery, P.C.
• Northwest Indiana Treatment Center, LLC (MedMark Treatment Centers Merrillville)

• Legal Medicine in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Legal Medicine in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; 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.