MACKENZIE S WARRICK


Address: 53880 Carmichael Dr, South Bend, IN 46635-1567
Phone: 5742479441

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
IN INDIANA MEDICAL LICENSE 10002823A 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
60160 Bodnar Blvd, Mishawaka, IN 465449338 5742479441 5742479442

Office Location

Street Address 53880 CARMICHAEL DR
City SOUTH BEND
State IN
Zip Code 46635-1567

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City SOUTH BEND
Zip Code 46635

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Dataset Information

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.

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