TIMOTHY PRIMROSE (NPI# 1578934402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578934402 |
| Entity Type | Individual |
| Full Name | TIMOTHY PRIMROSE |
| Credential | NP |
| Practice Address |
5215 Holy Cross Pkwy Mishawaka IN 46545-1469 |
| Mailing Address |
Po Box 6309 Sjpn Cbo South Bend IN 46660-6309 |
| Practice Telephone | 5743354145 |
| Practice Fax Number | 5743354146 |
| Mailing Telephone | 5743358700 |
| Mailing Fax Number | 5743350741 |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2015-12-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 71005880A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
71005880A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201327760 | 05 | |
| IN | BCBS | 000000969840 | 01 |
| Street Address |
5215 HOLY CROSS PKWY |
| City | MISHAWAKA |
| State | IN |
| Zip Code | 46545-1469 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164422002 | Jonathan Neil Shenk | Emergency Medicine | 5215 Holy Cross Pkwy, Emergency Department, Mishawaka, IN 46545-1469 | 2005-07-21 |
| 1962022145 | Caramia Hummer | Respiratory Therapist, Registered | 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 | 2020-04-17 |
| 1174174635 | Laura Droege | Registered Nurse | 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 | 2019-09-26 |
| 1558916668 | Jordan Thomas Alberda | Nurse Practitioner | 5215 Holy Cross Pkwy, Mishawaka, IN 46545 | 2019-08-06 |
| 1881161214 | Alexi Bellchambers | Physician Assistant | 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 | 2018-10-24 |
| 1033697529 | Hospitalist Medicine Physicians of Indiana-tcg, LLC | Internal Medicine | 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 | 2018-08-06 |
| 1154818011 | Mary Irvin | Specialist/Technologist | 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 | 2018-04-17 |
| 1093219008 | Mayelin Lora-williams | Dietitian, Registered | 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 | 2018-03-23 |
| 1013446566 | Gevorg Martirosyan | Student in an Organized Health Care Education/Training Program | 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 | 2017-06-08 |
| 1699207530 | Julie Sauer | Nurse Practitioner | 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 | 2017-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649824103 | Senior Helpers | In Home Supportive Care | 230 Catalpa Drive Suite B, Mishawaka, IN 46545 | 2019-08-01 |
| 1093272114 | Candice Marie Greathouse | Physical Therapy Assistant | 3630 Hickory Road, Mishawaka, IN 46545 | 2019-02-25 |
| 1639662596 | Mishawaka Rcf Lp | Assisted Living Facility | 3630 Hickory Rd, Mishawaka, IN 46545 | 2018-06-14 |
| 1760907299 | Timothy John Howard | Emergency Medicine | 610 1/2 N Main Street, Apartment 1, Mishawaka, IN 46545 | 2017-08-05 |
| 1699203612 | Paridhie Vasudevan | Dentist | 6502 Grape Rd Ste 882, Mishawaka, IN 46545 | 2017-06-03 |
| 1780134650 | Ossip Optometry, PC | Optometrist | 5111 N. Main Street, Suite 200, Mishawaka, IN 46545 | 2016-10-04 |
| 1457730038 | Melissa Anne Douthit | Nurse Practitioner | 3665 Park Pl W Ste 300, Mishawaka, IN 46545 | 2015-05-28 |
| 1558759654 | Spine and Joint Associates of Plymouth, Inc | Chiropractor | 229 Red Coach, Suite 106, Mishawaka, IN 46545 | 2014-12-26 |
| 1609264795 | Spine and Joint Associates of Mishawaka, Inc | Chiropractor | 229 Red Coach Trail, Suite 106, Mishawaka, IN 46545 | 2014-12-26 |
| 1508260795 | Maribel Smith | Counselor | 2989 Heritage Ct, Mishawaka, IN 46545 | 2014-10-16 |
| Find all providers in zip 46545 | ||||
| Taxonomy Code | 363LN0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Neonatal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497000798 | Ashley Nicole Coak | Nurse Practitioner | 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 | 2012-07-23 |
| 1285931063 | Vickie Ragle | Nurse Practitioner | 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 | 2011-02-14 |
| 1356642987 | Dana Ann Kolbus | Nurse Practitioner | 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 | 2010-11-12 |
| 1215010806 | Mary C Martin-hemphill | Nurse Practitioner | 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770981201 | Jamie Hembrecht | Nurse Practitioner | 615 N Michigan St Hospitalist Suite 1st Floor, South Bend, IN 46601-1033 | 2014-12-16 |
| 1174817563 | Regina Ann Rogers | Nurse Practitioner | 2520 East Dupont Road, Nicu, Fort Wayne, IN 46825 | 2011-06-03 |
| 1679716534 | Amber Michelle Wallace | Nurse Practitioner | 615 N. Michigan St.- 1st Floor Hospitalist Suite, South Bend, IN 46601-1469 | 2009-04-08 |
| 1356942056 | Catherine Marie Boggs | Nurse Practitioner | 720 Eskenazi Ave, Indianapolis, IN 46202-5187 | 2020-11-08 |
| 1265050207 | Katelyn R. Redman | Nurse Practitioner | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2020-07-07 |
| 1245857796 | Heather Dawn Fitch | Nurse Practitioner | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2020-07-01 |
| 1891327730 | Claire Richey | Nurse Practitioner | 8111 Township Line Rd, Indianapolis, IN 46260-2479 | 2020-02-09 |
| 1538717848 | Emily Mastelou-page | Nurse Practitioner | 615 N Michigan St, South Bend, IN 46601-1033 | 2019-08-29 |
| 1184286791 | Casey Joanne Callahan | Nurse Practitioner | 705 Riley Hospital Dr, Rr 208, Indianapolis, IN 46202-5109 | 2019-07-03 |
| 1770144347 | Kari L. Lappin | Nurse Practitioner | 705 Riley Hospital Dr, Rr 208, Indianapolis, IN 46202-5109 | 2019-06-25 |
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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.