ST MARY MEDICAL CENTER INC (NPI# 1083925333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083925333 |
| Entity Type | Organization |
| Organization Name | ST MARY MEDICAL CENTER INC |
| Other Organization Name | INNOVATIVE WOMENS HEALTH |
| Practice Address |
3545 Arbors Street Portage IN 46368-4297 |
| Mailing Address |
9660 Wicker Avenue St John IN 46373-9487 |
| Practice Telephone | 2197596092 |
| Practice Fax Number | 2197596580 |
| Mailing Telephone | 2192262203 |
| Mailing Fax Number | 2192262202 |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2010-07-01 |
| Authorized Official Name | JANICE RYBA (CEO) |
| Authorized Official Telephone | 2199420551 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST MARY MEDICAL CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| INNOVATIVE WOMENS HEALTH | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609188598 | St Mary Medical Center Inc | Nurse Practitioner | 850 Marsh Street, Suite C, Valparaiso, IN 46385-6239 | 2010-07-08 |
| 1922319318 | St Mary Medical Center Inc | Obstetrics & Gynecology | 1551 S Sturdy Road, Valparaiso, IN 46383-7883 | 2010-06-30 |
| 1851306690 | St Mary Medical Center Inc | Internal Medicine | 209 E 86th Ct, Merrillville, IN 46410-6529 | 2006-07-30 |
| 1902198831 | St Mary Medical Center Inc | General Practice | 2000 Roosevelt Rd, Ste 5, Valparaiso, IN 46383-2800 | 2011-05-11 |
| 1932417854 | St Mary Medical Center Inc | Urology | 10607 Randolph St, C, Crown Point, IN 46307-7505 | 2010-09-14 |
| 1336457225 | St Mary Medical Center Inc | Surgery | 1600 S Lake Park Ave, 1102, Hobart, IN 46342-6641 | 2010-09-14 |
| 1639498975 | St Mary Medical Center Inc | Urology | 3545 Arbors Street, Portage, IN 46368-4298 | 2010-05-26 |
| 1932427523 | St Mary Medical Center Inc | Obstetrics & Gynecology | 1400 S Lake Park Ave, Ste 205, Hobart, IN 46342-6790 | 2010-05-07 |
| 1598083347 | St Mary Medical Center Inc | Urology | 1400 S Lake Park Ave, Ste 407, Hobart, IN 46342-6790 | 2010-05-04 |
| 1992022958 | St Mary Medical Center Inc | Urology | 1400 S Lake Park Ave, Ste 105, Hobart, IN 46342-6790 | 2010-04-29 |
| Street Address |
3545 ARBORS STREET |
| City | PORTAGE |
| State | IN |
| Zip Code | 46368-4297 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033443106 | Munster Medical Research Foundatio | Obstetrics & Gynecology | 3545 Arbors Street, Portage, IN 46368-4297 | 2009-09-23 |
| 1639498975 | St Mary Medical Center Inc | Urology | 3545 Arbors Street, Portage, IN 46368-4298 | 2010-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1831576693 | Bishara Robert Khoury | Family Medicine | 3545 Arbor Blvd Ste E, Portage, IN 46368 | 2015-04-30 |
| 1962813535 | Diane Farrington | Pharmacist | 6050 Us Hwy 6, Portage, IN 46368 | 2014-05-16 |
| 1588827562 | Jennifer Ann Rumpel | Allergy & Immunology | 6375 Us Highway 6 Ste C, Portage, IN 46368 | 2008-07-09 |
| 1588822688 | Total Renal Care Inc | Clinic/Center | 5823 Us Highway 6, Portage, IN 46368 | 2008-05-27 |
| 1235321480 | Michael Wendahl | Physical Therapist | 3691 Willowcreek Road, Suite 100, Portage, IN 46368 | 2007-08-13 |
| 1679663603 | Stephen V Headley | Family Medicine | 3283 Willowcreek Rd, Portage, IN 46368 | 2006-10-13 |
| 1730276486 | Robert Tan Ang | Psychiatry & Neurology | 3156 Willowcreek Road, Portage, IN 46368 | 2006-10-06 |
| 1013029883 | Primary Care PC | Family Medicine | 3125 Willowcreek Road, Portage, IN 46368 | 2006-08-31 |
| 1104936962 | Margaret Eileen Griffith | Dentist | 2646 Lois Street, Portage, IN 46368 | 2006-08-30 |
| Find all providers in zip 46368 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992870398 | The Woman's Wellness Center, P.C. | Obstetrics & Gynecology | 3630 Willowcreek Road, Suite 10, Portage, IN 46368-5075 | 2006-11-21 |
| 1033162425 | Travis Haldeman | Obstetrics & Gynecology | 3545 Arbor Blvd, Portage, IN 46368-4298 | 2006-05-18 |
| 1801852165 | Daniel Lawrence Lott | Obstetrics & Gynecology | 3564 Scottsdale St, Portage, IN 46368-5420 | 2006-04-25 |
| 1649250242 | Scott M Peterson | Obstetrics & Gynecology | 3300 W Centre Ave, Bronson Ob Gyn Associates, Portage, MI 49024-4666 | 2006-01-19 |
| 1083976682 | Sara Lynn Deatsman | Obstetrics & Gynecology | 3300 W Centre Ave, Portage, MI 49024-4666 | 2012-06-11 |
| 1538459813 | Amber Rachelle Nash-guilford | Obstetrics & Gynecology | 7895 Currier Dr, Portage, MI 49002-4314 | 2011-04-08 |
| 1689841165 | Women's Medical Care LLC | Obstetrics & Gynecology | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2008-05-13 |
| 1285856245 | Jessica Lynn Puckett | Obstetrics & Gynecology | 3300 W Centre Ave, Portage, MI 49024-4666 | 2007-05-02 |
| 1952453474 | Jennifer Margaret Carman | Obstetrics & Gynecology | 3300 W Centre Ave, Portage, MI 49024-4666 | 2007-01-17 |
| 1104922483 | Miljan R Stankovic | Obstetrics & Gynecology | 3564 Scottsdale St, Portage, IN 46368-5420 | 2006-09-15 |
| Find all providers in PORTAGE | ||||
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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.