Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1255371514 Individual Practitioner Female Practitioner

Dr. Olivia Grayce Tack , MD

Pediatrics • Granger, IN

Professional Overview & Biography Verified Profile Summary

Dr. Olivia Tack, MD is a registered healthcare professional specializing in Pediatrics in Granger, IN. Practice services are available at 6913 N MAIN ST STE 200 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

6913 N Main St Ste 200

Granger, IN 465308039

Telephone 5746474540
Fax 5746472567
Associated Practice Facility / Clinic
🏢 Beacon Medical Group, Inc. Facility NPI 1447203674

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Granger, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.8 Yrs
Regional Practice Density
11 Specialists

Practicing in Granger, IN (1179 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-11-24
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License IN 01062281A

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
200828650 (IN)
Commercial Insurance / Payer ID Medicare Ptan
247000031 (IN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

12 Associated Practitioners
NPI 1134214240

Doctor of Medicine (M.D.)

Kathleen George

Family Medicine

NPI 1194305474
NPI 1285622373

Doctor of Medicine (M.D.)

Madison Parker , NP

Nurse Practitioner - Family

NPI 1407580533

Nurse Practitioner

Therese Steinmetz , MSN, PNP

Nurse Practitioner - Pediatrics

NPI 1417923756

Master of Science in Nursing, Pediatric Nurse Practitioner

NPI 1467610352

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
📍
Updated Practice Location November 24, 2025

Registered at 6913 N MAIN ST STE 200, GRANGER, IN 465308039 (Tel: 5746474540)

📍
Updated Business Mailing Address November 24, 2025

Registered at 3245 HEALTH DR STE 100, GRANGER, IN 465301380 (Tel: 5746472713)

📍
Updated Practice Location October 23, 2018

Registered at 2235 CLEVELAND RD, SOUTH BEND, IN 466283529 (Tel: 5746474530)

NPI Profile Active December 08, 2017

NPI status registered as active in NPPES database

📍
Updated Business Mailing Address December 08, 2017

Registered at 710 N NILES AVE, SOUTH BEND, IN 466171924 (Tel: 5746471610)

📍
Updated Practice Location December 08, 2017

Registered at 6913 N MAIN ST, GRANGER, IN 465308039 (Tel: 5746472970)

👤
Provider Name / Credentials Updated December 08, 2017

Recorded as OLIVIA TACK, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 08, 2017

Pediatrics (License #01062281A in IN)

NPI Profile Active October 12, 2009

NPI status registered as active in NPPES database

📍
Updated Practice Location October 12, 2009

Registered at 6913 N MAIN ST, GRANGER, IN 465308039 (Tel: 5746472970)

📍
Updated Business Mailing Address October 12, 2009

Registered at 3355 DOUGLAS RD, SUITE 300, SOUTH BEND, IN 466351781

👤
Provider Name / Credentials Updated October 12, 2009

Recorded as OLIVIA TACK, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 12, 2009

Pediatrics (License #01062281A in IN)

🟢
Initial NPI Registration & Enumeration June 07, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1255371514
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 07, 2006
Last Update: November 24, 2025
Sole Proprietor: No

Mailing Address

3245 Health Dr Ste 100

Granger, IN 465301380

Phone: 5746472713

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.