MARK M WALSH (NPI# 1427048099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427048099 |
| Entity Type | Individual |
| Full Name | MARK M WALSH |
| Credential | MD |
| Practice Address |
801 E Lasalle Emergency Department South Bend IN 46617-2814 |
| Mailing Address |
3371 Cleveland Rd Suite 210 South Bend IN 46628-9780 |
| Practice Telephone | 5742377111 |
| Practice Fax Number | 5742731137 |
| Mailing Telephone | 5742712558 |
| Mailing Fax Number | 5742731137 |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2008-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
01035916A | IN | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 01035916A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100318660 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427581065 | Mark J. Walsh | Dentist | 4s615 Karns Rd, Naperville, IL 60563-1508 | 2017-04-11 |
| 1891901484 | Mark Edward Walsh | Chiropractor | 7305 N Alta Ave, Portland, OR 97203-4807 | 2007-05-14 |
| 1003952318 | Mark Kim Walsh | Ophthalmology | 6561 E. Carondelet Dr., Tucson, AZ 85710-2161 | 2007-01-30 |
| 1265473813 | Mark D Walsh | Family Medicine | 7611 Hwy 76, Suite C, Pendleton, SC 29670 | 2006-06-08 |
| 1174513675 | Mark Walsh | Physical Medicine & Rehabilitation | 1623 Morgantown Rd, Reading, PA 19607-9455 | 2005-10-26 |
| 1508866906 | Mark Thomas Walsh | Physical Therapist | 24 Macarthur Blvd., Somers Point, NJ 08244 | 2005-07-28 |
| 1033425608 | Mark Walsh | Student in an Organized Health Care Education/Training Program | 3333 Burnet Ave, Ml 5018, Cincinnati, OH 45229-3039 | 2010-08-20 |
| 1093850737 | Mark David Walsh | Psychiatry & Neurology | 106 Milford St, Suite 306, Salisbury, MD 21804-6962 | 2007-02-20 |
| 1144376724 | Mark Walsh Jr. | Plastic Surgery | 550 Peachtree St Ne, 8th Floor, Suite 4300, Atlanta, GA 30308-2208 | 2007-01-26 |
| 1346215613 | Mark J Walsh | Internal Medicine | 75 Sylvania Dr, Dayton, OH 45440-3237 | 2006-02-21 |
| Street Address |
801 E LASALLE EMERGENCY DEPARTMENT |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46617-2814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114077294 | Angela Susan Gallagher | Speech-Language Pathologist | 801 E Lasalle, South Bend, IN 46617 | 2007-01-11 |
| 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 | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285994434 | Aaron Brooks Crofoot | Emergency Medicine | 229 W North Shore Dr, South Bend, IN 46617-1142 | 2012-05-22 |
| 1952364218 | George Knowles | Emergency Medicine | 801 E Lasalle Ave, South Bend, IN 46617-2814 | 2006-04-08 |
| 1245292903 | James Devereaux | Emergency Medicine | 801 E Lasalle Ave, South Bend, IN 46617-2814 | 2006-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346871217 | Nw Indiana Ep, LLC | Emergency Medicine | 7904 Cabela Dr, Hammond, IN 46324-2950 | 2020-01-30 |
| 1801383278 | Midwest Emergency Medicine, Inc. | Emergency Medicine | 520 S 7th Street, Er, Vincennes, IN 47591-1038 | 2018-04-20 |
| 1689842262 | James Scott Frasure | Emergency Medicine | 4030 W Breezewood Ct, Bloomington, IN 47404-9132 | 2008-02-15 |
| 1831290956 | Suzanne M Coleman | Emergency Medicine | 3124 E State Blvd Ste 2b, Fort Wayne, IN 46805-4763 | 2006-09-25 |
| 1194772681 | Paula Lange | Emergency Medicine | 3252 Tantara Bnd, Carmel, IN 46032-8733 | 2006-05-28 |
| 1982658886 | Robert L Goddard Jr. | Emergency Medicine | 817 W Rosewood Dr, Bloomington, IN 47404-1849 | 2006-05-22 |
| 1295796985 | Thomas S Spencer | Emergency Medicine | 104 E Culver Rd, Suite 103, Knox, IN 46534-2216 | 2006-03-31 |
| 1609844166 | Joseph V Lazzara | Emergency Medicine | 8633 N State Road 550, Bruceville, IN 47516-6096 | 2006-03-10 |
| 1417558271 | Daviess County Hospital | Emergency Medicine | 1314 E Walnut St, Washington, IN 47501-2860 | 2020-11-06 |
| 1851816656 | Lacey Diane Maul | Emergency Medicine | 1907 W Sycamore St, Kokomo, IN 46901-5148 | 2017-08-14 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46617 |
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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.