NPIMap

Organization Active NPI

Medspa Womans Healthcare PC

  • Obstetrics & Gynecology Physician
  • Michigan City, IN
National Provider Identifier
1891845418
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
01052711A Issued in IN
Legal business name
MEDSPA WOMANS HEALTHCARE PC
Practice address
601 Kieffer Road
Michigan City, IN 46360
Phone
(219) 879-6262
Fax
(219) 874-1885
NPI assigned
Jan 12, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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. Julius Rodney Ellis, MDNPI 1194734145
Title
Owner
Phone
(219) 362-4690

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
Obstetrics & Gynecology Physician 207V00000X 01052711A IN Primary

Addresses

Primary practice location

601 Kieffer Road
Michigan City, IN 46360

Mailing address

PO Box 9721
Michigan City, IN 46361-9721
Phone (219) 362-4690

National Provider Directory

National Provider Directory
Tax ID family
Med Spa Womans Healthcare3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891845418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9721",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463619721",
            "telephone_number": "219-362-4690",
            "fax_number": "219-362-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 KIEFFER ROAD",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "46360",
            "telephone_number": "219-879-6262",
            "fax_number": "219-874-1885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSPA WOMANS HEALTHCARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JULIUS",
        "authorized_official_middle_name": "RODNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-362-4690",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01052711A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, 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.