LINDA HIGGINBOTHAM (NPI# 1134189053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134189053 |
| Entity Type | Individual |
| Full Name | LINDA HIGGINBOTHAM |
| Credential | MD |
| Practice Address |
211 N Eddy St South Bend IN 46617-2808 |
| Practice Telephone | 5742379231 |
| Practice Fax Number | 5742046355 |
| Mailing Telephone | 5742379231 |
| Mailing Fax Number | 5742046355 |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2018-06-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | G53699 | CA | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | 01069131A | IN | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | LH044277 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | GREAT LAKES HELATH PLAN | 142732 | 01 |
| MI | 3093970 | 05 | |
| MI | AETNA | 447756 | 01 |
| IN | ANTHEM PROVIDER NUMBER | 000000699107 | 01 |
| IN | 201035670 | 05 | |
| MI | OMNICARE HEALTH PLAN | 50842 | 01 |
| IN | ANTHEM BCBS PIN | 000000733964 | 01 |
| MI | BCBSM/BCN | 070H263730 | 01 |
| Street Address |
211 N EDDY ST |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46617-2808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073511598 | Ron Clark | Orthopaedic Surgery | 211 N Eddy St, South Bend, IN 46617-2808 | 2005-07-08 |
| 1760082002 | Nicole A Scheidler | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-3096 | 2020-10-27 |
| 1205473451 | Integrative Care Partners LLC | Specialist | 211 N Eddy St, South Bend, IN 46617-2808 | 2019-12-06 |
| 1144882069 | Briana R Weidler-edholm | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-3096 | 2019-07-01 |
| 1861052029 | Suzanne Marie Holmes | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-3096 | 2019-06-19 |
| 1609436864 | Philip D Dibert | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-3096 | 2019-06-19 |
| 1851865174 | Jessica S Evans | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-2808 | 2019-01-21 |
| 1467929570 | Sabrina Jovita Lopez | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-2808 | 2018-10-26 |
| 1326515701 | Kara L Kaiser | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-2808 | 2018-10-24 |
| 1962902254 | Sarah Sue Humes | Registered Nurse | 211 N Eddy St, South Bend, IN 46617 | 2018-02-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740731116 | Jack Mcintyre Kimmell | Specialist/Technologist | 1526 East Lasalle, South Bend, IN 46617 | 2016-10-20 |
| 1023429115 | Morning View Assisted Living LLC | Assisted Living Facility | 475 N. Niles Avenue, South Bend, IN 46617 | 2014-05-12 |
| 1265861231 | Rebecca Busenbark | Physical Therapist | 401 E Colfax Ave Ste 102, South Bend, IN 46617 | 2013-11-11 |
| 1962709071 | Doreen Danice Huddleston | Social Worker | 928 East Wayne St, Suit C, South Bend, IN 46617 | 2011-02-25 |
| 1487981734 | Mary Cecilia Roemer | Marriage & Family Therapist | 616 E. Colfax Ave, South Bend, IN 46617 | 2009-11-06 |
| 1225264054 | Sridhar Meda | Dentist | 1005 East Lasalle Ave, South Bend, IN 46617 | 2009-06-08 |
| 1063673531 | Madeline Christina Watkins | Counselor | 616 E Colfax, South Bend, IN 46617 | 2008-06-18 |
| 1437366481 | Michael Reed Johns | Dentist | 103 South Eddy Street, South Bend, IN 46617 | 2007-05-17 |
| 1194937680 | Sarah Elizabeth Redman | Specialist/Technologist | 53880 Carmichael Dr., South Bend, IN 46617 | 2007-05-04 |
| 1124241211 | Trixy Franke | Family Medicine | 837 E. Cedar St., Ste 100, South Bend, IN 46617 | 2007-04-10 |
| Find all providers in zip 46617 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245626225 | Kathleen Kelley | Dermatology | 1815 E Ireland Rd, South Bend, IN 46614 | 2015-04-07 |
| 1225321722 | Luiz C Pantalena Filho | Dermatology | 1815 E Ireland Rd, South Bend, IN 46614 | 2011-05-17 |
| 1821222829 | Beacon Medical Group, Inc. | Dermatology | 615 N Michigan St, First Floor Hospitalist Suite, South Bend, IN 46601 | 2009-05-06 |
| 1861482234 | Mary K Harder | Dermatology | 211 N Eddy St, South Bend, IN 46617-2808 | 2005-10-26 |
| 1649260233 | Cynthia E Mayfield | Dermatology | 2102 E Inwood Rd, South Bend, IN 46614-2443 | 2005-10-25 |
| 1538159207 | Holly L Hake-harris | Dermatology | 211 N Eddy St, South Bend, IN 46617-2808 | 2005-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457998692 | Medovate, LLC | Dermatology | 9305 Calumet Ave Ste A1, Munster, IN 46321-2888 | 2019-12-06 |
| 1386107829 | Strausburg Dermatology Group LLC | Dermatology | 92 S Park Blvd, Greenwood, IN 46143-8836 | 2019-04-11 |
| 1467834127 | Emily W Shelley | Dermatology | 8433 Harcourt Rd Ste 310, Indianapolis, IN 46260-2198 | 2015-06-18 |
| 1396133518 | Forefront Dermatology, S.c. | Dermatology | 188 State Road 129 S. Ste B, Batesville Medical Arts Bldg, Batesville, IN 47006 | 2014-12-23 |
| 1003211392 | Forefront Dermatology, S.c. | Dermatology | 1473 N Gardner St Ste A, C/o Scott Memorial Hospital, Scottsburg, IN 47170 | 2014-10-29 |
| 1639580152 | Nikolajs Perdue | Dermatology | 6820 Parkdale Pl Ste 211, Indianapolis, IN 46254-6600 | 2014-05-19 |
| 1356785778 | Larry Gene Bond | Dermatology | 9637 W. County Rd 200 N., Frankfort, IN 46041 | 2013-04-29 |
| 1093057911 | Matthew Bradley Strausburg | Dermatology | 9292 N Meridian St Ste 210, Indianapolis, IN 46260-1828 | 2013-03-18 |
| 1730430513 | Robert Marshall Weiss | Dermatology | 6017 Benchmark-one, Floyds Knobs, IN 47119-9410 | 2012-09-20 |
| 1346597655 | Franciscan Medical Specialists | Dermatology | 757-45th Street, Ste 201, Munster, IN 46321 | 2012-08-07 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46617 |
Please comment or provide details below to improve the information on LINDA HIGGINBOTHAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.