NPIMap

Organization Active NPI

Indiana University Health la Porte Hospital Inc

  • Dental Clinic/Center
  • La Porte, IN
National Provider Identifier
1992884878
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
11-005006-1 Issued in IN
Legal business name
INDIANA UNIVERSITY HEALTH LA PORTE HOSPITAL INC
Practice address
400 Teegarden
La Porte, IN 46350-3175
Phone
(219) 326-2403
Fax
(219) 326-2385
NPI assigned
Nov 3, 2006
Reactivated
Aug 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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

Authorized official

Name
G Thor Thordarson
Title
President/Ceo
Phone
(219) 326-2555

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 06-005006-1 IN
Dental Clinic/Center 261QD0000X 11-005006-1 IN Primary

Addresses

Primary practice location

400 Teegarden
La Porte, IN 46350-3175

Mailing address

400 Teegarden
La Porte, IN 46350-3175
Phone (219) 326-2403

Other identifiers 1

IdentifierTypeStateIssuer
200237780AMedicaidIN

Other names 1

  • Community Health Center of LaPorte Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Laporte Regional Health System Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379289600000",
    "number": "1992884878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 TEEGARDEN",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503175",
            "telephone_number": "219-326-2403",
            "fax_number": "219-326-2385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TEEGARDEN",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503175",
            "telephone_number": "219-326-2403",
            "fax_number": "219-326-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA UNIVERSITY HEALTH LA PORTE HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2013-09-16",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "THORDARSON",
        "authorized_official_first_name": "G",
        "authorized_official_middle_name": "THOR",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "219-326-2555"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IN",
            "license": "06-005006-1",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IN",
            "license": "11-005006-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200237780A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Center of LaPorte",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Porte, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; 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.