| Nwi Mdvip Llc | |
|
9150 E 109th Ave Ste 2b Crown Point IN 46307-7686 | |
| (219) 213-2947 | |
| (219) 310-8175 |
| Full Name | Nwi Mdvip Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 9150 E 109th Ave Ste 2b, Crown Point, Indiana |
| Authorized Official Name and Position | Brent A Jacobus (OWNER) |
| Authorized Official Contact | 2193060752 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nwi Mdvip Llc 9150 E 109th Ave Ste 2b Crown Point IN 46307-7686 Ph: (219) 306-0752 | Nwi Mdvip Llc 9150 E 109th Ave Ste 2b Crown Point IN 46307-7686 Ph: (219) 213-2947 |
| NPI Number | 1538877972 |
|---|---|
| Provider Enumeration Date | 11/14/2022 |
| Last Update Date | 11/14/2022 |
| Medicare PECOS PAC ID | 0042683690 |
|---|---|
| Medicare Enrollment ID | O20230301000520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538877972 | NPI | - | NPPES |
| 200380090 | Medicaid | IN | |
| 100200720 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Brett A Brechner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629079108 PECOS PAC ID: 6002887049 Enrollment ID: I20040804000103 |
| Provider Name | Brent A Jacobus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902807589 PECOS PAC ID: 2163494162 Enrollment ID: I20040810001164 |
Jab Sports Medicine & Direct Primary Care Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5521 W Lincoln Hwy Ste 230, Crown Point, IN 46307 Phone: 219-301-1158 Fax: 219-301-1158 | |
The Good Doctor, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 952 S Court St, Crown Point, IN 46307 Phone: 219-226-0650 Fax: 219-226-0618 | |
219 Health Network, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10215 Broadway, Crown Point, IN 46307 Phone: 219-661-6152 Fax: 219-703-6833 | |
Elite Diagnostics Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10996 Four Seasons Pl, Ste 100a, Crown Point, IN 46307 Phone: 888-339-7339 Fax: 312-254-1421 | |
Prestige 2 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11360 Broadway, Crown Point, IN 46307 Phone: 219-301-2624 | |
Hospice Of America, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1229 Arrowhead Ct, Crown Point, IN 46307 Phone: 219-661-3100 | |
Pinnacle Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9301 Connecticut Dr, Crown Point, IN 46307 Phone: 219-796-4150 |