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EDGEWATER HEALTH: LAKE STREET PEDIATRICS
NPI 1245907344
Clinic/Center - Federally Qualified Health Center (FQHC) in Gary, IN

Active since August 26, 2021

NPPES record last updated: August 26, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Edgewater Health: Lake Street Pediatrics NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDGEWATER HEALTH: LAKE STREET PEDIATRICS (NPI 1245907344) is a healthcare organization registered as a federally qualified health center (fqhc) in Gary, Indiana and active in the NPI registry since August 2021. The organization lists Danita Johnson Hughes, Ceo, as its authorized official.

NPPES Registry Identity

NPI1245907344
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameEDGEWATER SYSTEMS FOR BALANCED LIVING, INC
Location Address426 S LAKE STGary, IN 46403-2405
Mailing Address1100 W 6th AveGary, IN 46402-1711 · (219) 885-4264
Phone(219) 939-6070
Organization SubpartNo
Authorized OfficialDanita Johnson HughesCeo · (219) 885-4264
Enumeration DateAugust 26, 2021
NPPES CertifiedAugust 26, 2021
✔ NPI 1245907344 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
426 S LAKE ST, Gary, IN 46403
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Other Names 1

Doing Business AsEdgewater Health: Lake Street Pediatrics

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource.Insurance ›

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAKE COUNTY WALKER MEDICAL
General Practice
426 S LAKE ST
GARY, IN 46403
Lake County (219) 939-6070
WALKER MEDICAL LLC
General Practice
426 S LAKE ST
GARY, IN 46403
Lake County (219) 939-8970
MS. MICHELLE BREUNIG DNP, CNS, FNP-C
Nurse Practitioner (Family)
426 S LAKE ST
GARY, IN 46403
Lake County (219) 939-6070

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edgewater Systems For Balanced Living, Inc's NPI number?

The NPI number for Edgewater Systems For Balanced Living, Inc is 1245907344. It was assigned to this organization in the NPPES registry on August 26, 2021. The provider is doing business as Edgewater Health: Lake Street Pediatrics.

Where is Edgewater Systems For Balanced Living, Inc located?

Edgewater Systems For Balanced Living, Inc is located at 426 S Lake St, Gary, IN 46403. The listed phone number is (219) 939-6070.

What is Edgewater Systems For Balanced Living, Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

What insurance does Edgewater Systems For Balanced Living, Inc accept?

Health plans from Anthem Blue Cross and Blue Shield and CareSource list Edgewater Systems For Balanced Living, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Edgewater Systems For Balanced Living, Inc was last updated on August 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.