INDIANA HEALTH CENTERS, INC (NPI# 1598776742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598776742 |
| Entity Type | Organization |
| Organization Name | INDIANA HEALTH CENTERS, INC |
| Other Organization Name | INDIANA HEALTH CENTERS SOUTH BEND AT OAKLAWN |
| Practice Address |
415 E Madison St South Bend IN 46617-2322 |
| Mailing Address |
8003 Castleway Dr Indianapolis IN 46250-1946 |
| Practice Telephone | 5742349033 |
| Practice Fax Number | 5742349059 |
| Mailing Telephone | 3175761335 |
| Mailing Fax Number | 3175761339 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2014-05-28 |
| Authorized Official Name | DR. TERRANCE J. DRAKE (CHIEF MEDICAL OFFICER) |
| Authorized Official Telephone | 3175761335 |
| Authorized Official Credential | M.D., F.A.A.P. |
| Is Organization Subpart | Y |
| Parent Organization Name | INDIANA HEALTH CENTERS, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 100223780 | IN | Dental Providers |
| N | 207R00000X | Internal Medicine | 200527220 | IN | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 200284500A | IN | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | 01023827A | IN | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 200443050 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 1000071250 | 05 |
| Other Name | Type Code |
|---|---|
| Indiana Health Centers South Bend at Oaklawn | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154862829 | Indiana Health Centers, Inc | Family Medicine | 421 12th Street, Logansport, IN 46947-3539 | 2017-03-15 |
| 1558629634 | Indiana Health Centers, Inc | Clinic/Center | 1102 Fellows St, South Bend, IN 46601-3514 | 2012-04-26 |
| 1649559196 | Indiana Health Centers, Inc | Family Medicine | 121 Locust Ln, Nashville, IN 47448-7021 | 2011-08-15 |
| 1376143198 | Indiana Health Centers, Inc | Family Medicine | 401 E 8th St Ste A, Rochester, IN 46975-1444 | 2020-10-30 |
| 1609315829 | Indiana Health Centers, Inc | Family Medicine | 35 Bob Babbs Dr, Spencer, IN 47460-6828 | 2017-02-21 |
| 1780065672 | Indiana Health Centers, Inc | Family Medicine | 1010 N Bendix Dr, South Bend, IN 46628-1925 | 2015-06-16 |
| 1215343389 | Indiana Health Centers, Inc | Family Medicine | 206 W 8th St, Marion, IN 46953-1921 | 2014-07-09 |
| 1124434469 | Indiana Health Centers, Inc | Family Medicine | 120 Saint Louis Ave, Seymour, IN 47274-2304 | 2014-07-08 |
| 1912327693 | Indiana Health Centers, Inc | Family Medicine | 415 E Madison St, South Bend, IN 46617-2322 | 2014-04-22 |
| 1336373190 | Indiana Health Centers, Inc | Clinic/Center | 661 E Main St, Peru, IN 46970-2662 | 2009-05-08 |
| Street Address |
415 E MADISON ST |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46617-2322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841287950 | Amanda Jane Duddleson | Social Worker | 415 E Madison St, South Bend, IN 46617-2322 | 2005-10-04 |
| 1144829961 | Allen O'carey | Counselor | 415 E Madison St, South Bend, IN 46617-2322 | 2020-10-22 |
| 1922607779 | Tekona Henry | Counselor | 415 E Madison St, South Bend, IN 46617-2322 | 2020-10-22 |
| 1093314452 | Darell Ezell II | Counselor | 415 E Madison St, South Bend, IN 46617-2322 | 2020-10-18 |
| 1386243749 | Karen Bruening | Counselor | 415 E Madison St, South Bend, IN 46617-2322 | 2020-10-18 |
| 1457966988 | Kelly Holst-haley | Counselor | 415 E Madison St, South Bend, IN 46617-2322 | 2020-09-11 |
| 1942814694 | Bailey Ritsema | Counselor | 415 E Madison St, South Bend, IN 46617-2322 | 2020-09-01 |
| 1053924662 | Seanell Williams | Counselor | 415 E Madison St, South Bend, IN 46617-2322 | 2020-08-25 |
| 1285247890 | Dana A Taylor | Counselor | 415 E Madison St, South Bend, IN 46617-2322 | 2020-08-25 |
| 1245840040 | Mathew Peters | Social Worker | 415 E Madison St, South Bend, IN 46617-2322 | 2020-08-06 |
| Find all providers in the same location | ||||
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285998146 | Thomas Larsen | Family Medicine | 4440 Portage Ave, South Bend, IN 46628-9570 | 2012-06-26 |
| 1316180318 | Paul Angelo Carl Macri | Family Medicine | 2012 Cedar St, South Bend, IN 46617-2542 | 2009-04-07 |
| 1285818591 | Jaroslaw Kuna | Family Medicine | 320 S Saint Joseph St Ste 300, South Bend, IN 46601-2308 | 2007-12-21 |
| 1013117472 | Ronald E Grow Inc | Family Medicine | 810 W Indiana Ave, South Bend, IN 46613-1828 | 2007-07-23 |
| 1124241211 | Trixy Franke | Family Medicine | 837 E. Cedar St., Ste 100, South Bend, IN 46617 | 2007-04-10 |
| 1225185739 | Michael J. O'connell D.o. Inc | Family Medicine | 17960 Cleveland Road, South Bend, IN 46635 | 2007-01-05 |
| 1679620579 | Mark R. Neff | Family Medicine | 804 Lancaster Dr, South Bend, IN 46614-2020 | 2007-01-04 |
| 1437216587 | David Wood Baxter | Family Medicine | 115 E Cripe St, South Bend, IN 46637-3402 | 2007-01-01 |
| 1477635944 | Alan Snell | Family Medicine | 837 East Cedar St., Ste 100, South Bend, IN 46617 | 2006-10-20 |
| 1437240694 | Brian Anthony Jacobs | Family Medicine | 610 N Michigan Street, Suite 308, South Bend, IN 46601 | 2006-09-27 |
| Find all providers in SOUTH BEND | ||||
| 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.