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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: July 19, 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.

MS. MICHELLE BREUNIG DNP, CNS, FNP-C
Nurse Practitioner (Family)
426 S LAKE ST
GARY, IN 46403
Lake County (219) 939-6070
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

Frequently Asked Questions

What is EDGEWATER SYSTEMS FOR BALANCED LIVING, INC's NPI number?

The NPI number assigned to this healthcare provider is 1245907344, enumerated as an "organization" on August 26, 2021.

Where is the provider located?

The provider is located at 426 S LAKE ST GARY, IN 46403 and the phone number is (219) 939-6070.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).

What insurance does EDGEWATER SYSTEMS FOR BALANCED LIVING, INC accept?

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield and CareSource. Please consult your insurance carrier or call the provider to verify.