St. John Therapy Services, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

05006512A Issued in IN

Legal business name

ST. JOHN THERAPY SERVICES, INC.

Practice address

9111 Broadway
Suite MM
Merrillville, IN 46410-8122

Phone

(219) 750-9763

NPI assigned

Oct 18, 2011

Last updated

Oct 18, 2011By 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

Mr. Ian C Caballes, P.TNPI 1568719268

Title

Administrator

Phone

(219) 716-0030

Specialties & licenses 1

Addresses

Locations

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.

• Ian Christian Caballes, P.T

  • Physical Therapist
  • Schererville, IN
  • NPI 1568719268
  NPD (past) Authorized official

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1902181233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10197 BACKWATER CV",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463737008",
            "telephone_number": "219-750-9763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9111 BROADWAY",
            "address_2": "SUITE MM",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464108122",
            "telephone_number": "219-750-9763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN THERAPY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-18",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "CABALLES",
        "authorized_official_first_name": "IAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "219-716-0030",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IN",
            "license": "05006512A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; 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.