SOUTH BEND EMERGENCY PHYSICIANS, INC (NPI# 1487132114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487132114 |
| Entity Type | Organization |
| Organization Name | SOUTH BEND EMERGENCY PHYSICIANS, INC |
| Practice Address |
615 N Michigan St South Bend IN 46601-1033 |
| Mailing Address |
7725 W Reno Ave Ste 330 Oklahoma City OK 73127-9742 |
| Practice Telephone | 5742991945 |
| Mailing Telephone | 8009623303 |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2018-08-03 |
| Authorized Official Name | MICHAEL BLAKESLEY (PRESIDENT) |
| Authorized Official Telephone | 5742991945 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
615 N MICHIGAN ST |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46601-1033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003801283 | Russell F Johnson | Radiology | 615 N Michigan St, 1st Floor, South Bend, IN 46601-1033 | 2005-09-14 |
| 1265048078 | Sarah Ellen Pritt | Technician | 615 N Michigan St, South Bend, IN 46601-1087 | 2020-09-17 |
| 1740803238 | Taylor Reinhardt | Physician Assistant | 615 N Michigan St, South Bend, IN 46601-1033 | 2020-05-19 |
| 1720613268 | Jennifer Lynn Boyd | Pharmacist | 615 N Michigan St, South Bend, IN 46601-1087 | 2020-03-05 |
| 1104451798 | Ryan Lipinski | Pharmacist | 615 N Michigan St, South Bend, IN 46601-1033 | 2020-03-04 |
| 1669007241 | Alexandra Rain Ross | Pharmacist | 615 N Michigan St, South Bend, IN 46601-1087 | 2020-03-04 |
| 1538717848 | Emily Mastelou-page | Nurse Practitioner | 615 N Michigan St, South Bend, IN 46601-1033 | 2019-08-29 |
| 1477021038 | Ashlee Dennise Swafford | Physician Assistant | 615 N Michigan St, South Bend, IN 46601-1033 | 2018-11-12 |
| 1962993386 | Gail Gronek Weismann | Dietitian, Registered | 615 N Michigan St, South Bend, IN 46601-1033 | 2018-05-21 |
| 1487145017 | Cecily Maes | Dietitian, Registered | 615 N Michigan St, South Bend, IN 46601-1087 | 2018-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447610449 | David Thomas | Hearing Instrument Specialist | 808 S Michigan St., South Bend, IN 46601 | 2016-03-03 |
| 1285072454 | Kevin Francis Cumper | Internal Medicine | 621 Memorial Dr Ste 624, South Bend, IN 46601 | 2013-06-11 |
| 1952605560 | Robert Lusk Bonham | Dentist | 1222 L.w.e., So. Bend, IN 46601 | 2010-12-23 |
| 1649580911 | Daniel Scott Debrule | Psychologist | 211 W. Washington Street, Suite 2311, South Bend, IN 46601 | 2010-10-20 |
| 1528390770 | Luke Alfred White | Internal Medicine | 615 N. Michigan St., Memorial Hospital, C/o Erin Smith, South Bend, IN 46601 | 2010-02-12 |
| 1548497837 | Tmg Home Health Care | Home Health | 108 N Main St #305, South Bend, IN 46601 | 2009-06-15 |
| 1225283039 | Jody L. Hughes | Counselor | 202 S. Michigan Street, Suite 875, South Bend, IN 46601 | 2008-11-20 |
| 1740432574 | Amanda Jayne Quicksall | Social Worker | 611 Lincolnway W, South Bend, IN 46601 | 2008-10-10 |
| 1952565772 | Thomas P Judd | Dentist | 1901 #b Western Avenue, Ihc South Bend, South Bend, IN 46601 | 2008-07-10 |
| 1851590269 | Warren Larry Penrod | Nurse Practitioner | 333 W. Western Ave, South Bend, IN 46601 | 2007-07-16 |
| Find all providers in zip 46601 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457730830 | Patrick Lee Studtman | Emergency Medicine | 615 N. Michigan Street, Emergency Department, South Bend, IN 46601-1033 | 2015-05-19 |
| 1710937388 | Sunday Osunnuga | Emergency Medicine | 615 N Michigan St Fl 1, South Bend, IN 46601-1033 | 2006-05-12 |
| 1194110767 | Cheryl Wibbens | Emergency Medicine | 615 N Michigan St, South Bend, IN 46601-1033 | 2015-04-01 |
| 1851701841 | Gregory J Pettaway II | Emergency Medicine | 615 N Michigan St, South Bend, IN 46601-1033 | 2014-04-30 |
| 1235578055 | Aoko Doris Crain | Emergency Medicine | 615 N Michigan St, South Bend, IN 46601-1033 | 2013-06-14 |
| 1902063480 | Joseph Paul D'haenens | Emergency Medicine | 615 N Michigan St, South Bend, IN 46601-1033 | 2008-05-21 |
| 1407051634 | Nicole Davis Riordan | Emergency Medicine | 615 N Michigan St, South Bend, IN 46601-1033 | 2007-06-18 |
| 1386864643 | Debra D Slapper | Emergency Medicine | 800 Alder Street, South Bend, WA 98586 | 2007-04-27 |
| 1861615510 | Gregory Carden Gifford | Emergency Medicine | 111 Sunnybrook Ct, South Bend, IN 46637-3437 | 2007-04-11 |
| 1548347826 | Richard Harry Seall | Emergency Medicine | 615 N Michigan St, South Bend, IN 46601-1033 | 2006-11-01 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46601 |
Please comment or provide details below to improve the information on SOUTH BEND EMERGENCY PHYSICIANS, INC.
| 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.