1477698991 NPI number — RICHARD O. ONI, MD, INC

Table of content: (NPI 1477698991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477698991 NPI number — RICHARD O. ONI, MD, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICHARD O. ONI, MD, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ORTHOPAEDIC SURGEONS, LTD.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477698991
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5525 BROADWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERRILLVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46410-2782
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-884-1551
Provider Business Mailing Address Fax Number:
219-887-6334

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5525 BROADWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERRILLVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46410-2782
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
219-884-1551
Provider Business Practice Location Address Fax Number:
219-887-6334
Provider Enumeration Date:
02/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ONI
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
O
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
219-884-1551

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  01030980A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200014830B , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100166600A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000085298 . This is a "BCBS OF INDIANA" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200014830A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 91107850 . This is a "BCBS OF ILL" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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