Jon D. Misch, D.O.,P.C.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

02000900 Issued in IN

Legal business name

JON D. MISCH, D.O.,P.C.

Practice address

13963 Morse St
Cedar Lake, IN 46303-9639

Phone

(219) 374-5555

Fax

(219) 374-6669

NPI assigned

May 7, 2007

Reactivated

May 7, 2010

Last updated

May 7, 2010By 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

Dr. Jon D. Misch, D.O.NPI 1790767465

Title

President

Phone

(219) 374-5555

Specialties & licenses 1

Addresses

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.

• Jon D Misch, D.O.

  • Family Medicine Physician
  • Cedar Lake, IN
  • NPI 1790767465
  NPD (past) Authorized official

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273190400000",
    "number": "1972716082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13963 MORSE ST",
            "city": "CEDAR LAKE",
            "state": "IN",
            "postal_code": "463039639",
            "telephone_number": "219-374-5555",
            "fax_number": "219-374-6669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13963 MORSE ST",
            "city": "CEDAR LAKE",
            "state": "IN",
            "postal_code": "463039639",
            "telephone_number": "219-374-5555",
            "fax_number": "219-374-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JON D. MISCH, D.O.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2010-05-07",
        "deactivation_date": "2010-04-08",
        "reactivation_date": "2010-05-07",
        "status": "A",
        "authorized_official_last_name": "MISCH",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-374-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "IN",
            "license": "02000900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Cedar Lake, IN
• Providers in Cedar Lake, IN by specialty
• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2010; 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.