NORTHSHORE HEALTH CENTERS INC. NPI 1407061336

NPI Information

NPI: 1407061336
Provider Name: NORTHSHORE HEALTH CENTERS, INC.
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
Phone: (219) 763-8112
Get Directions

NORTHSHORE HEALTH CENTERS, INC. is a federally qualified health center (fqhc) clinic center in Portage, IN. NORTHSHORE HEALTH CENTERS, INC. NPI is 1407061336. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368-752
Phone: (219) 763-8112
Fax: (219) 764-5380

The provider's authorized official is David Hall .
The authorized official title is Ceo and has the following contact phone number (219) 763-8112.

The enumeration date for this NPI number is 5/14/2007 and was last updated on 9/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
2	1041C0700X	Social Worker	Clinical	No
3	111N00000X	Chiropractor		No
4	122300000X	Dentist		No
5	152W00000X	Optometrist		No
6	207Q00000X	Family Medicine		No
7	207RE0101X	Internal Medicine	Endocrinology, Diabetes & Metabolism	No
8	207V00000X	Obstetrics & Gynecology		No
9	208000000X	Pediatrics		No
10	2084P0800X	Psychiatry & Neurology	Psychiatry	No
11	2085R0202X	Radiology	Diagnostic Radiology	No
12	2085U0001X	Radiology	Diagnostic Ultrasound	No
13	363LF0000X	Nurse Practitioner	Family	No
14	363LW0102X	Nurse Practitioner	Women's Health	No
15	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	151834	OTHER	INDIANA	MERICARE PART A PTAN
2	191360	OTHER	INDIANA	MEDICARE PART B PTAN
3	200331170B	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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