JILL M. MADDOX (NPI# 1437388220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437388220 |
| Entity Type | Individual |
| Full Name | JILL M. MADDOX |
| Credential | N.P. |
| 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 | 5742913351 |
| Mailing Telephone | 5746471610 |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2016-08-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 71002976 | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | RR MEDICARE | P01672697 | 01 |
| IN | BCBS BMG IRELAND | 000000973275 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942471552 | Jill Helaine Maddox | Psychiatry & Neurology | 2212 3rd Ave, 5th Floor, New York, NY 10035-3530 | 2008-03-23 |
| 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 |
| 1518123124 | Daniel Matthew Kinney | Pediatrics | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2008-08-03 |
| 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 | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417574013 | Hellen Gathesha | Nurse Practitioner | 2123 W Irvington Dr, South Bend, IN 46614 | 2020-06-30 |
| 1073042024 | Emilee Tehrani | Nurse Practitioner | 621 Memorial Dr Ste 512, South Bend, IN 46601-1075 | 2017-06-05 |
| 1952836884 | Ryan Ford | Nurse Practitioner | 2301 N Bendix Dr Ste 500, South Bend, IN 46628-3488 | 2017-04-28 |
| 1124563614 | Alexandrea Burnett | Nurse Practitioner | 211 N. Eddy St., South Bend, IN 46617-3096 | 2016-12-20 |
| 1265700090 | Gregory George Bingaman | Nurse Practitioner | 710 N Niles Ave, South Bend, IN 46617-1924 | 2011-12-07 |
| 1679768774 | Kyra Dee Tatman | Nurse Practitioner | 615 N Michigan St Ste 502, South Bend, IN 46601-1033 | 2007-09-11 |
| 1386686996 | Rhonda Y Griffiths | Nurse Practitioner | 234 Chapin St, Suite I, South Bend, IN 46601-2570 | 2006-06-11 |
| 1083665673 | Beacon Medical Group, Inc. | Nurse Practitioner | 926 Erskine Plz, South Bend, IN 46614-3244 | 2006-05-16 |
| 1699763409 | Patricia Ann Corbett | Nurse Practitioner | 1708 High St, South Bend, IN 46613-2633 | 2005-10-06 |
| 1760082002 | Nicole A Scheidler | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-3096 | 2020-10-27 |
| 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.