JODY JOSEPH (NPI# 1861663510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861663510 |
| Entity Type | Individual |
| Full Name | JODY JOSEPH |
| Credential | FNP |
| Practice Address |
2349 Lake Ave Ste 100 Plymouth IN 46563-7836 |
| Mailing Address |
Po Box 6309 South Bend IN 46660-6309 |
| Practice Telephone | 5744726700 |
| Practice Fax Number | 5749413112 |
| Mailing Telephone | 5744726700 |
| Mailing Fax Number | 5743350760 |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2013-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71002470A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM, BCBS | 000000562397 | 01 |
| IN | BCBS | 000000726441 | 01 |
| BCBS | 000000726441 | 01 | |
| IN | 200893890 | 05 |
| Street Address |
2349 LAKE AVE STE 100 |
| City | PLYMOUTH |
| State | IN |
| Zip Code | 46563-7836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023139821 | Jennifer Robyn Friberg | Nurse Practitioner | 2349 Lake Ave Ste 100, Plymouth, IN 46563-7836 | 2007-04-02 |
| 1578195913 | Nicole B Bolinger | Registered Nurse | 2349 Lake Ave Ste 100, Plymouth, IN 46563-7836 | 2020-02-04 |
| 1629514799 | Dawn Campbell | Nurse Practitioner | 2349 Lake Ave Ste 100, Plymouth, IN 46563-7836 | 2017-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811547748 | Steven N Wolff | Pharmacist | Walmart #1978, 2505 North Oak Drive, Plymouth, IN 46563 | 2019-09-12 |
| 1295280923 | Multi-county Ems LLC | Ambulance | 5034 Redwood Road, Plymouth, IN 46563 | 2016-08-23 |
| 1356473060 | Donna Michelle Eggers | Speech-Language Pathologist | 1915 Lake Avenue, Plymouth, IN 46563 | 2007-03-09 |
| 1629103684 | Marshall County Council On Aging | Home Delivered Meals | 1305 W Harrison Street, Plymouth, IN 46563 | 2007-02-22 |
| 1063561272 | Associates In Clinical Psychology PC | Psychiatric Residential Treatment Facility | 317 West Monroe St, Plymouth, IN 46563 | 2007-01-09 |
| 1316005911 | Michiana Eye Center LLC | Optometrist | 320 Meadow Ln, Plymouth, IN 46563 | 2006-12-05 |
| 1487722948 | Allen Edward Reese | Hearing Instrument Specialist | 322 N. Michigan St., Suite C, Plymouth, IN 46563 | 2006-12-01 |
| 1508932252 | Thomas A Miller | Chiropractor | 1071 Lincolnway E, Plymouth, IN 46563 | 2006-11-27 |
| 1679540991 | Mukesh Garg | Internal Medicine | 2349 Lake Ave Ste 99, Plymouth, IN 46563 | 2006-03-06 |
| 1982686242 | Woodlawn Hospital | Skilled Nursing Facility | 9601 Union Rd, Plymouth, IN 46563 | 2005-11-14 |
| Find all providers in zip 46563 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477180826 | Stephanie Jordan | Nurse Practitioner | 22 Cranberry Rd, Plymouth, MA 02360-2857 | 2020-03-25 |
| 1710543863 | Kristen Marie Kubik | Nurse Practitioner | 13970 Oakland Ct, Plymouth, MI 48170-5292 | 2019-05-14 |
| 1679931505 | Hillary Costa | Nurse Practitioner | 45 Resnik Rd Ste 302, Plymouth, MA 02360-4883 | 2016-02-06 |
| 1811374747 | Jill Marie Geer | Nurse Practitioner | 510 W Adams St, Suite 150, Plymouth, IN 46563-1765 | 2015-04-29 |
| 1740677921 | Inner Banks Family Medicine | Nurse Practitioner | 543 Us Highway 64 W, Plymouth, NC 27962-2144 | 2015-04-24 |
| 1952706210 | Elizabeth Nelson-frazier | Nurse Practitioner | 50 Aldren Road, Plymouth, MA 02061-2711 | 2014-10-29 |
| 1902206899 | Kathleen E Steensma | Nurse Practitioner | 15700 37th Ave N. #110, Plymouth, MN 55446 | 2014-08-27 |
| 1730595943 | Nicole Lee | Nurse Practitioner | 10 Bay Cliff Cir, Plymouth, MA 02360-1458 | 2014-07-08 |
| 1700122579 | Renae Charlene Atkins | Nurse Practitioner | 2855 Miller Dr Ste 119, Plymouth, IN 46563-8091 | 2012-12-21 |
| 1396097069 | Kristin Lynn Spencer | Nurse Practitioner | 3007 Harbor Lane North, Park Nicollet Clinic Plymouth - Family Medicine, Plymouth, MN 55447 | 2012-10-05 |
| Find all providers in PLYMOUTH | ||||
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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.