Porter County Endoscopy Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

06004288 Issued in IN

Legal business name

PORTER COUNTY ENDOSCOPY CENTER, LLC

Doing business as

Endolabs

Practice address

2206 Roosevelt Rd
Suite B
Valparaiso, IN 46383-2749

Phone

(219) 548-9990

NPI assigned

Oct 11, 2006

Organization subpart

No

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

Authorized official

Name

Stephen Paul, MD

Title

Administrator

Phone

(219) 934-5300

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Endolabs Doing business as

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227571200000",
    "number": "1902994924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 ROOSEVELT RD",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832749",
            "telephone_number": "219-548-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 ROOSEVELT RD",
            "address_2": "SUITE B",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832749",
            "telephone_number": "219-548-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTER COUNTY ENDOSCOPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-11-25",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "219-934-5300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IN",
            "license": "06004288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200513280A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endolabs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Porter
• Porter County Anesthesia Associates PC
• Porter County Auditors Office (Porter County Health Department)
• Porter County Chiropractic Clinic Inc.
• Porter County Community Services, Inc
• Porter County Family Counseling Center
• Porter County Family Counseling Center
• Porter County Internal Medicine PC
• Porter County Physical Med Rehab
• Porter County Pulmonary and Critical Care Medicine P.C.

• Ambulatory Surgical Clinic/Center in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Ambulatory Surgical Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2008; 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.