DR. JEROME RUSCEAK SKELLY (NPI# 1396729893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396729893 |
| Entity Type | Individual |
| Full Name | DR. JEROME RUSCEAK SKELLY |
| Credential | M.D. |
| Practice Address |
1815 E Ireland Rd South Bend IN 46614-2845 |
| Mailing Address |
710 N Niles Ave South Bend IN 46617-1924 |
| Practice Telephone | 5746471700 |
| Practice Fax Number | 5746471993 |
| Mailing Telephone | (574) 647-1610 |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2017-07-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 01049640A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200203460 | 05 |
| Street Address |
1815 E IRELAND RD |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46614-2845 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396733101 | Douglas Mayer David | Family Medicine | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2005-10-06 |
| 1699322446 | Evelin Keultjes | Nurse Practitioner | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2019-08-26 |
| 1548766249 | Dena Nichole Garnett | Physical Therapist | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2018-04-02 |
| 1467909697 | Sarah Anne Martin | Physician Assistant | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2016-09-06 |
| 1245685510 | Kristin Jamison | Nurse Practitioner | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2016-04-25 |
| 1245626225 | Kathleen Kelley | Dermatology | 1815 E Ireland Rd, South Bend, IN 46614 | 2015-04-07 |
| 1881085967 | Shanti T Dalson | Physical Therapist | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2015-02-11 |
| 1144660838 | Amanda Leanne Springer | Family Medicine | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2013-06-27 |
| 1225321722 | Luiz C Pantalena Filho | Dermatology | 1815 E Ireland Rd, South Bend, IN 46614 | 2011-05-17 |
| 1437388220 | Jill M. Maddox | Nurse Practitioner | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2009-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417574013 | Hellen Gathesha | Nurse Practitioner | 2123 W Irvington Dr, South Bend, IN 46614 | 2020-06-30 |
| 1033759394 | Diane Galvas | Pharmacist | 1217 E. Ireland Rd., South Bend, IN 46614 | 2020-01-14 |
| 1730668690 | Julenne Henriquez-gil | Physical Therapist | 202 W Ireland Rd Ste 101a, South Bend, IN 46614 | 2018-08-11 |
| 1467747014 | Deidre A Coffey | Nurse Practitioner | 1025 Widener Ln, South Bend, IN 46614 | 2011-06-12 |
| 1588727655 | Wal-mart Stores East, Lp | Technician/Technologist | 700 W. Ireland Rd., South Bend, IN 46614 | 2006-12-19 |
| 1437262847 | Lori F Risser | Dentist | 734 E Ireland Rd, South Bend, IN 46614 | 2006-08-17 |
| 1912388018 | Laura Ellen Albright | Family Medicine | 2102 E Inwood Rd, South Bend, IN 46614 | 2015-06-15 |
| 1073869806 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1950 Ridgedale Rd, South Bend, IN 46614 | 2012-07-30 |
| 1326300666 | Kristine Marie Jones | Optometrist | 700 W Ireland Rd, South Bend, IN 46614 | 2012-06-12 |
| 1760766968 | John Thomas Miller | Pharmacist | 1010 E Ireland Rd, South Bend, IN 46614 | 2011-10-06 |
| Find all providers in zip 46614 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962862334 | Saint Jude Offices, LLC | Internal Medicine | 328 N Michigan St, Suite F3, South Bend, IN 46601-1244 | 2016-02-29 |
| 1396154324 | Saint Joseph Regional Medical Center South Bend Campus, Inc. | Internal Medicine | 234 Chapin St Ste I (i), South Bend, IN 46601-2571 | 2014-08-04 |
| 1285072454 | Kevin Francis Cumper | Internal Medicine | 621 Memorial Dr Ste 624, South Bend, IN 46601 | 2013-06-11 |
| 1528390770 | Luke Alfred White | Internal Medicine | 615 N. Michigan St., Memorial Hospital, C/o Erin Smith, South Bend, IN 46601 | 2010-02-12 |
| 1225235336 | Sylvana Atallah | Internal Medicine | 328 N Michigan St Ste F3, First Floor, South Bend, IN 46601-1241 | 2007-07-02 |
| 1730194416 | Edna Pamatmat | Internal Medicine | 1901 W Western Ave Ste B, South Bend, IN 46619-3570 | 2006-07-30 |
| 1447220843 | Mark Douglas Fox | Internal Medicine | 1234 N Notre Dame Ave, South Bend, IN 46617-1404 | 2006-01-26 |
| 1649261710 | Susan R Hart-cavallo | Internal Medicine | 720 Cedar St, Suite 400, South Bend, IN 46617-2060 | 2005-10-28 |
| 1194102723 | Patricia C Osmolak | Internal Medicine | 615 N Michigan St Fl 1, South Bend, IN 46601-1033 | 2015-05-04 |
| 1285011957 | Jason Stegink | Internal Medicine | 615 N Michigan St, South Bend, IN 46601 | 2015-05-01 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46614 |
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| 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.