DR. TIMOTHY J DURHAM (NPI# 1811987613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811987613 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY J DURHAM |
| Credential | MD |
| Practice Address |
211 N Eddy St South Bend IN 46617-2808 |
| Practice Telephone | 5742337337 |
| Practice Fax Number | 5742391561 |
| Mailing Telephone | 5742337337 |
| Mailing Fax Number | 5742391561 |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2015-02-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 01035875A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100090860 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134644016 | Timothy Durham | Social Worker | 905 River Rd, Granville, OH 43023-9560 | 2017-08-11 |
| 1497209431 | Timothy R Durham | Case Manager/Care Coordinator | 322 Middleburg St, Liberty, KY 42539-3004 | 2016-08-08 |
| 1205972288 | Timothy Mark Durham | Dentist | 989375 Nebraska Medical Ctr, Omaha, NE 68198-9375 | 2007-01-29 |
| Street Address |
211 N EDDY ST |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46617-2808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073511598 | Ron Clark | Orthopaedic Surgery | 211 N Eddy St, South Bend, IN 46617-2808 | 2005-07-08 |
| 1760082002 | Nicole A Scheidler | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-3096 | 2020-10-27 |
| 1205473451 | Integrative Care Partners LLC | Specialist | 211 N Eddy St, South Bend, IN 46617-2808 | 2019-12-06 |
| 1144882069 | Briana R Weidler-edholm | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-3096 | 2019-07-01 |
| 1861052029 | Suzanne Marie Holmes | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-3096 | 2019-06-19 |
| 1609436864 | Philip D Dibert | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-3096 | 2019-06-19 |
| 1851865174 | Jessica S Evans | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-2808 | 2019-01-21 |
| 1467929570 | Sabrina Jovita Lopez | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-2808 | 2018-10-26 |
| 1326515701 | Kara L Kaiser | Nurse Practitioner | 211 N Eddy St, South Bend, IN 46617-2808 | 2018-10-24 |
| 1962902254 | Sarah Sue Humes | Registered Nurse | 211 N Eddy St, South Bend, IN 46617 | 2018-02-13 |
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497399927 | Primary Care Partners of South Bend | Pediatrics | 300 S Saint Louis Blvd Ste 204, South Bend, IN 46617-3044 | 2019-10-28 |
| 1407282833 | Jill O Noreuil | Pediatrics | 50665 Ravenna Ct, South Bend, IN 46628-9634 | 2013-09-17 |
| 1255958310 | Vpa PC | Pediatrics | 5838 W Brick Rd Ste 106, South Bend, IN 46628-8420 | 2020-07-06 |
| 1720605884 | Vpa PC | Pediatrics | 5838 W Brick Rd Ste 106, South Bend, IN 46628-8420 | 2020-07-06 |
| 1760923023 | Javier Galan | Pediatrics | 211 N Eddy St, South Bend, IN 46617-2808 | 2017-03-19 |
| 1366820359 | Bradley Balint | Pediatrics | 615 N Michigan St Fl 5, South Bend, IN 46601-1033 | 2015-05-11 |
| 1720474620 | Sarah O'connor | Pediatrics | 615 N Michigan St Fl 5, South Bend, IN 46601-1033 | 2015-04-08 |
| 1215322052 | Melanie Lillian Leveille Leusink | Pediatrics | 615 N Michigan St Fl 5, South Bend, IN 46601 | 2015-03-30 |
| 1245658004 | Bernadette Lourdes O'neil | Pediatrics | 615 N Michigan St, South Bend, IN 46601-1033 | 2014-03-30 |
| 1285070284 | Alicia Marie Wilson | Pediatrics | 211 N Eddy St, South Bend, IN 46617-3096 | 2013-05-16 |
| 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.