HEALTHLINC, INC. (NPI# 1679954804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679954804 |
| Entity Type | Organization |
| Organization Name | HEALTHLINC, INC. |
| Other Organization Name | HEALTHLINC - SOUTH BEND DENTAL |
| Practice Address |
1002 S Esther St South Bend IN 46615 |
| Mailing Address |
2401 Valley Dr Valparaiso IN 46383-2520 |
| Practice Telephone | 2194776082 |
| Practice Fax Number | 2194659502 |
| Mailing Telephone | 2194135100 |
| Mailing Fax Number | 2194659507 |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2018-06-06 |
| Authorized Official Name | SHIRLEY A ROLL (ENROLLMENT) |
| Authorized Official Telephone | 3174727396 |
| Is Organization Subpart | Y |
| Parent Organization Name | HEALTHLINC, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200317310G | 05 | |
| IN | MEDICARE | 193380 | 01 |
| Other Name | Type Code |
|---|---|
| HealthLinc - South Bend Dental | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215487608 | Healthlinc, Inc. | Clinic/Center | 710 Franklin St Ste 200, Michigan City, IN 46360-3564 | 2016-10-10 |
| 1871985358 | Healthlinc, Inc. | Eyewear Supplier (Equipment, not the service) | 1001 Sturdy Rd, Valparaiso, IN 46383-4126 | 2015-02-20 |
| 1184069569 | Healthlinc, Inc. | Clinic/Center | 1313 W Chicago Ave, East Chicago, IN 46312 | 2013-04-30 |
| 1417244989 | Healthlinc, Inc. | Clinic/Center | 420 W 4th St, Mishawaka, IN 46544 | 2011-07-06 |
| 1023288032 | Healthlinc, Inc. | Clinic/Center | 701 Wall St, Valparaiso, IN 46383 | 2008-03-05 |
| 1013105568 | Healthlinc, Inc. | Clinic/Center | 710 Franklin St Ste 200, Michigan City, IN 46360 | 2007-10-10 |
| 1528262581 | Healthlinc, Inc. | Clinic/Center | 1001 Sturdy Rd, Valparaiso, IN 46383 | 2007-06-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HEALTHLINC, INC. | 2401 Valley Dr, Valparaiso, IN 46383-2520 |
| Street Address |
1002 S ESTHER ST |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467920892 | Mallory Edmondson | Dental Hygienist | 1002 S Esther St, South Bend, IN 46615-1440 | 2018-11-03 |
| 1841640521 | Andrea Ramthun | Dentist | 1002 S Esther St, South Bend, IN 46615-1440 | 2016-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861897688 | Michelle Jean Streb | Registered Nurse | 1960 Northside Boulevard, South Bend, IN 46615 | 2014-10-23 |
| 1275848962 | Charles Mikel Craig | Optometrist | 220 N. Ironwood Dr., South Bend, IN 46615 | 2010-08-18 |
| 1710219613 | Debra Vasquez | Occupational Therapy Assistant | 1950 Ridgedaleroad, South Bend, IN 46615 | 2010-02-03 |
| 1114259132 | Christopher Joseph Smith | Physical Therapist | 1005 Hickory Rd, South Bend, IN 46615 | 2010-02-01 |
| 1295064525 | Starlight Care Facilities, Inc | Skilled Nursing Facility | 915 So. 27th Street, South Bend, IN 46615 | 2009-12-16 |
| 1699002642 | Ann G Pryor | Contractor | 1516 E. Wayne St., South Bend, IN 46615 | 2009-11-12 |
| 1891917449 | Logan Community Resources, Inc. | Community/Behavioral Health | 2505 E. Jefferson Blvd, South Bend, IN 46615 | 2007-05-03 |
| 1487712683 | Julie Gaydos Plagens | Dentist | 604 South Eddy St, South Bend, IN 46615 | 2006-12-04 |
| 1629163084 | Edward F Klodzinski | Counselor | 3603 E. Jefferson Blvd., South Bend, IN 46615 | 2006-10-03 |
| 1255448452 | John D Bond Dds Inc | Dentist | 915 S Ironwood, South Bend, IN 46615 | 2006-08-24 |
| Find all providers in zip 46615 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558629634 | Indiana Health Centers, Inc | Clinic/Center | 1102 Fellows St, South Bend, IN 46601-3514 | 2012-04-26 |
| 1972071769 | Healthlinc, Inc | Clinic/Center | 621 Memorial Dr Ste 402, South Bend, IN 46601-1074 | 2018-11-09 |
| 1811465602 | Healthlinc, Inc | Clinic/Center | 1708 High St, South Bend, IN 46613-2633 | 2018-11-09 |
| 1790158244 | Healthlinc, Inc | Clinic/Center | 1960 Northside Boulevard, South Bend, IN 46615 | 2015-11-05 |
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| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46615 |
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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.