NORTHSHORE HEALTH CENTERS, INC (NPI# 1023440526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023440526 |
| Entity Type | Organization |
| Organization Name | NORTHSHORE HEALTH CENTERS, INC |
| Other Organization Name | NORTHSHORE HAMMOND HEALTH CENTER |
| Practice Address |
6920 Indianapolis Blvd Hammond IN 46324-2206 |
| Mailing Address |
Po Box 1430 Portage IN 46368-9230 |
| Practice Telephone | 2197638112 |
| Practice Fax Number | 2198449006 |
| Mailing Telephone | 2197638112 |
| Mailing Fax Number | 2197645380 |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2020-09-22 |
| Authorized Official Name | DAVID HALL (CEO) |
| Authorized Official Telephone | 2197638112 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| N | 124Q00000X | Dental Hygienist | Dental Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 367A00000X | Advanced Practice Midwife | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | MEDICARE PART B PTAN | 191360 | 01 |
| IN | MEDICARE PART A PTAN | 151912 | 01 |
| IN | 200331170H | 05 |
| Other Name | Type Code |
|---|---|
| NorthShore Hammond Health Center | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTHSHORE HEALTH CENTERS, INC | 6450 Us Highway 6, Portage, IN 46368-5110 |
| Street Address |
6920 INDIANAPOLIS BLVD |
| City | HAMMOND |
| State | IN |
| Zip Code | 46324-2206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033101753 | Vanessa R Foster | Obstetrics & Gynecology | 6920 Indianapolis Blvd, Hammond, IN 46324-2206 | 2005-08-18 |
| 1578958278 | Aditya Shah | Family Medicine | 6920 Indianapolis Blvd, Hammond, IN 46324 | 2015-03-31 |
| 1013270024 | Dana Elsherif | Family Medicine | 6920 Indianapolis Blvd, Hammond, IN 46324-2206 | 2012-06-25 |
| 1629338777 | Shawn Phillip Naranjo | Obstetrics & Gynecology | 6920 Indianapolis Blvd, Hammond, IN 46324 | 2012-05-23 |
| 1700174299 | Keith Brian Douts Jr. | Dentist | 6920 Indianapolis Blvd, Hammond, IN 46324-2206 | 2011-07-18 |
| 1639409352 | Arshia Anjum Mohiuddin | Nurse Practitioner | 6920 Indianapolis Blvd, Hammond, IN 46324-1150 | 2009-12-31 |
| 1306173786 | Mary T Ellis | Advanced Practice Midwife | 6920 Indianapolis Blvd, Hammond, IN 46324-2206 | 2009-11-05 |
| 1487787602 | Isil Halac | Pediatrics | 6920 Indianapolis Blvd, Hammond, IN 46324-2206 | 2007-03-14 |
| 1154454346 | Lawrence Lyn Adams | Dentist | 6920 Indianapolis Blvd, Hammond, IN 46324-2206 | 2007-03-14 |
| 1629188743 | Cesar Mikels Labitan Jr. | Family Medicine | 6920 Indianapolis Blvd, Hammond, IN 46324-2206 | 2006-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174183024 | Northwest Indiana Hospital, LLC | General Acute Care Hospital | 7904 Cabela Dr., Hammond, IN 46324 | 2019-06-13 |
| 1679049779 | Secure Dental Viii | Dentist | 7905 Indianapolis Blvd, Indianan, IN 46324 | 2018-10-17 |
| 1710317615 | Christopher Keown-belous | Marriage & Family Therapist | 7030 Indianapolis Blvd, Hammond, IN 46324 | 2013-11-14 |
| 1316296114 | Planned Parenthood of Indiana Hammond | Clinic/Center | 7131 Indianapolis Blvd., Hammond, IN 46324 | 2012-09-07 |
| 1427343862 | Amanda Rose Popovich | Behavioral Analyst | 7110 Magoun Avenue, Hammond, IN 46324 | 2011-06-14 |
| 1588804751 | Tanesha Marnise Williams | Technician | 5831 Erie St, Hammond, IN 46324 | 2009-03-02 |
| 1417039652 | Debra Antoinette Petersen | Nurse Practitioner | 7131 Indianapolis Blvd, Hammond, IN 46324 | 2006-10-19 |
| 1568455467 | Elisabeth Cleary Shearon | Pathology | Alvero Clinical Laboratories, 3434 Interstate Plaza Dr, Hammond, IN 46324 | 2005-08-25 |
| 1770928509 | Hammond Dental Group LLC | Dentist | 6414 Calumet Ave, Hammond, IN 46324 | 2013-05-07 |
| 1922178540 | Jay David Karol | Dentist | 7134 Calumet Ave, Hammond, IN 46324 | 2006-11-09 |
| Find all providers in zip 46324 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023642576 | Southlake Community Mental Health Center Inc. | Clinic/Center | 2250 173rd St Ste 111, Hammond, IN 46323-2074 | 2020-02-24 |
| 1376062513 | Southeast Community Health Systems | Clinic/Center | 43052 Yokum Rd, Hammond, LA 70403-6351 | 2017-09-19 |
| 1194277806 | Southeast Community Health Systems | Clinic/Center | 501 Erwin Neil Way Hammond, Hammond, LA 70403 | 2016-10-28 |
| 1568810794 | Southeast Community Health Systems | Clinic/Center | 1500 Phoenix Sq, Hammond, LA 70403-3954 | 2016-05-27 |
| 1841647013 | Southeast Community Health Systems | Clinic/Center | 125 W Tornado Dr, Hammond, LA 70401-1334 | 2016-05-18 |
| 1790163715 | Access Health Louisiana | Clinic/Center | 42351 Phyllis Ann Dr, Hammond, LA 70403-1254 | 2015-05-11 |
| 1508297540 | Southlake Community Mental Health Center, Inc. | Clinic/Center | 527 State St, Hammond, IN 46320-1533 | 2013-12-02 |
| 1881946267 | Community Healthnet, Inc | Clinic/Center | 5927 Columbia Ave, Hammond, IN 46320-2611 | 2012-10-09 |
| 1366617367 | Southeast Community Health Systems | Clinic/Center | 30575 Old Baton Rouge Highway, Hammond, LA 70403 | 2008-04-30 |
| 1265080295 | Access Health Louisiana | Clinic/Center | 2545 Veterans Ave, Hammond, LA 70403-1513 | 2019-09-03 |
| Find all providers in HAMMOND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.