MACKENZIE S WARRICK (NPI# 1730720301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730720301 |
| Entity Type | Individual |
| Full Name | MACKENZIE S WARRICK |
| Other Name | MACKENZIE S REDMAN |
| Credential | PA |
| Practice Address |
53880 Carmichael Dr South Bend IN 46635-1567 |
| Practice Telephone | 5742479441 |
| Practice Fax Number | 5742479442 |
| Mailing Telephone | 5742479441 |
| Mailing Fax Number | 5742479442 |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2020-06-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | INDIANA MEDICAL LICENSE | 10002823A | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 60160 Bodnar Blvd, Mishawaka, IN 465449338 | 5742479441 | 5742479442 |
| Street Address |
53880 CARMICHAEL DR |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46635-1567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699764308 | Gary L. Armock | Physician Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2005-10-14 |
| 1972113496 | Jennifer Miller | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-10 |
| 1558971101 | Michelle Eichstedt | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-07 |
| 1316557390 | Kimberly Kinney | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-05 |
| 1023628005 | Melanie Daggy | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-05 |
| 1922618040 | Amy Tarwacki | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-04 |
| 1952950883 | Kyle Thomas Matheson | Physical Therapist | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2019-09-04 |
| 1851949440 | Karen Elizabeth Schneider-wensell | Physical Therapist | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2019-08-28 |
| 1174171763 | Elizabeth Anne Sullivan | Occupational Therapist | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2019-08-28 |
| 1386202265 | Anna K Vann | Occupational Therapist | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2019-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295078228 | Michael Pfeiffer | Otolaryngology | 6301 University Commons Ste 360, South Bend, IN 46635 | 2013-03-27 |
| 1679833438 | Whitney Moore | Physical Therapy Assistant | 2012 Ironwood Circle, Suite 230, Circle Centre Building, South Bend, IN 46635 | 2012-05-25 |
| 1992917637 | Elly May Wynia | Social Worker | 53700 Generations Drive, Suite 200, South Bend, IN 46635 | 2007-05-04 |
| 1891917282 | Lifetime Dental Careof Indiana, PC | Dentist | 1605 North Ironwood, South Bend, IN 46635 | 2007-05-03 |
| 1750502878 | Tyrone Arteese Armstead | Pharmacist | 3355 Douglas Rd, South Bend, IN 46635 | 2007-05-02 |
| 1013033794 | Bradley Richard Swanson | Dentist | 54505 26th Street, Unit E, South Bend, IN 46635 | 2007-03-22 |
| 1225185739 | Michael J. O'connell D.o. Inc | Family Medicine | 17960 Cleveland Road, South Bend, IN 46635 | 2007-01-05 |
| 1346300365 | Chad Fulton Harrington | Dentist | 3340 Douglas Rd., South Bend, IN 46635 | 2006-12-11 |
| 1346313236 | Dr Shawn R Long Dds PC | Dentist | 16329 State Rd 23, South Bend, IN 46635 | 2006-11-16 |
| 1134206576 | Kearn David Hinchman | Psychiatry & Neurology | 53779 Generations Drive, Suite 1, South Bend, IN 46635 | 2006-11-01 |
| Find all providers in zip 46635 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245421031 | Lisa D Raderstorf | Physician Assistant | 5838 W Brick Rd, Suite 106, South Bend, IN 46628-8423 | 2007-08-06 |
| 1316167307 | Dwaine Siade | Physician Assistant | 611 Lincoln Way East Suite 1, South Bend, IN 46601 | 2007-05-01 |
| 1699764308 | Gary L. Armock | Physician Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2005-10-14 |
| 1568454940 | Sheri A Wilson | Physician Assistant | 1245 E Ireland Rd, South Bend, IN 46614-3448 | 2005-08-22 |
| 1740803238 | Taylor Reinhardt | Physician Assistant | 615 N Michigan St, South Bend, IN 46601-1033 | 2020-05-19 |
| 1073155420 | Priya Kaur | Physician Assistant | 1245 E Ireland Rd, South Bend, IN 46614-3448 | 2019-10-16 |
| 1649736604 | Meghan M. Hart | Physician Assistant | 100 Navarre Pl Ste 4440, South Bend, IN 46601-1171 | 2019-02-14 |
| 1477021038 | Ashlee Dennise Swafford | Physician Assistant | 615 N Michigan St, South Bend, IN 46601-1033 | 2018-11-12 |
| 1801300330 | Alejandro Mikelonis | Physician Assistant | 610 N Michigan St Ste 306, South Bend, IN 46601-1079 | 2017-11-20 |
| 1295256808 | Elizabeth D. Progar | Physician Assistant | 610 N Michigan St Ste 306, South Bend, IN 46601-1079 | 2017-07-05 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46635 |
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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.