Provider Demographics
NPI:1043596703
Name:NWI URGENT CARE, LLC
Entity type:Organization
Organization Name:NWI URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CC SPECIALIST LEAD
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BATY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-789-6574
Mailing Address - Street 1:8135 CALUMET AVE
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321
Mailing Address - Country:US
Mailing Address - Phone:219-513-2000
Mailing Address - Fax:219-513-2001
Practice Address - Street 1:8135 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321
Practice Address - Country:US
Practice Address - Phone:219-513-2000
Practice Address - Fax:219-513-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-26
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X, 332B00000X, 332B00000X
IN01041056A261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201053130Medicaid
INM100065495Medicare UPIN
IN201053130Medicaid