Organization Active NPI

Calumet Quick Care LTD

  • Family Medicine Physician
  • Hammond, IN
National Provider Identifier
1861150419
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CALUMET QUICK CARE LTD
Practice address
5518 Calumet Ave
Hammond, IN 46320-2017
Phone
(219) 803-0379
NPI assigned
Dec 1, 2021
Last updated
Dec 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Richard O Watson, MDNPI 1962472886
Title
Owner
Phone
(888) 855-2995

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

5518 Calumet Ave
Hammond, IN 46320-2017

Mailing address

PO Box 786
Flossmoor, IL 60422-0786
Phone (219) 803-0379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221108002965 IN Part B Supplier - Clinic/Group Practice 9436526258 Receives reassigned benefits from 10 practitioners
Practice locations: East Chicago, IN; Hammond, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2267785Calumet Quick Care5518 Calumet Ave, Hammond, IN 46320Certificate of waiverMay 22, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1861150419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 786",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604220786",
            "telephone_number": "219-803-0379",
            "fax_number": "865-381-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5518 CALUMET AVE",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463202017",
            "telephone_number": "219-803-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALUMET QUICK CARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-01",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-855-2995",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.