Organization Active NPI

John Alexander Israel Consulting Inc

  • Psychologist
  • Michigan City, IN
National Provider Identifier
1942438718
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20042094A Issued in IN
Legal business name
JOHN ALEXANDER ISRAEL CONSULTING INC
Practice address
1401 S Woodland Ave Ste 3
Michigan City, IN 46360-7189
Phone
(219) 877-4758
NPI assigned
Jun 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Authorized official

Name
Tracy L Freeze
Title
Practice Administrator
Phone
(219) 926-8320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 20042094A IN Primary

Addresses

Primary practice location

1401 S Woodland Ave Ste 3
Michigan City, IN 46360-7189

Mailing address

PO Box 2257
Chesterton, IN 46304-0357
Phone (219) 926-8320

Other identifiers 1

IdentifierTypeStateIssuer
000000522563OtherINANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100610000475 IN Part B Supplier - Clinic/Group Practice 9335279884 Receives reassigned benefits from 1 practitioner
Practice locations: Michigan City, IN

National Provider Directory

National Provider Directory

Locations

1401 S Woodland Ave
Ste 3
Michigan City, IN 46360
Phone (219) 877-4758

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738540800000",
    "number": "1942438718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2257",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463040357",
            "telephone_number": "219-926-8320",
            "fax_number": "219-926-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S WOODLAND AVE STE 3",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607189",
            "telephone_number": "219-877-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN ALEXANDER ISRAEL CONSULTING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A",
        "authorized_official_last_name": "FREEZE",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "219-926-8320"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20042094A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000522563",
            "state": "IN"
        }
    ],
    "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 Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.