DR. RANDOLPH J. FERLIC (NPI# 1912989922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912989922 |
| Entity Type | Individual |
| Full Name | DR. RANDOLPH J. FERLIC |
| Credential | M.D. |
| 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 | 2005-11-16 |
| Last Update Date | 2007-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
01047894A | IN | Allopathic & Osteopathic Physicians |
| 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 |
| 1730720301 | Mackenzie S Warrick | Physician Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2019-10-03 |
| 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 |
| 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 | 207XS0106X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Hand Surgery |
| An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669421277 | South Bend Orthopaedic Associates, Inc. | Orthopaedic Surgery | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2006-05-09 |
| 1861474801 | John H Mahon | Orthopaedic Surgery | 6301 University Commons, Ste 420, South Bend, IN 46635 | 2005-11-16 |
| 1437131489 | Adelbert J. Mencias | Orthopaedic Surgery | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2005-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003000399 | Reconstructive Hand To Shoulder of Indiana, LLC | Orthopaedic Surgery | 13431 Old Meridian Street, Suite 225, Carmel, IN 46032 | 2007-08-30 |
| 1689873291 | Christian Hand Center, Inc | Orthopaedic Surgery | 1800 S. 3rd St., Terre Haute, IN 47802 | 2007-07-13 |
| 1598700783 | Michael E Pannunzio | Orthopaedic Surgery | 13431 Old Meridian St, Suite 225, Carmel, IN 46032-7101 | 2006-06-19 |
| 1295708659 | Richard L Makowiec | Orthopaedic Surgery | 5255 E Stop 11 Rd Ste 300, Indianapolis, IN 46237 | 2006-02-08 |
| 1497758429 | Fort Wayne Orthopaedics LLC | Orthopaedic Surgery | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2005-05-23 |
| 1639644560 | Orthocincy | Orthopaedic Surgery | 605 Wilson Creek Rd, Lawrenceburg, IN 47025-2506 | 2018-10-08 |
| 1912404435 | Thomas A Brady Sports Medicine Ctr | Orthopaedic Surgery | 639 S Walker St Ste E, Bloomington, IN 47403-2124 | 2018-04-11 |
| 1952790321 | Community Care Network, Inc | Orthopaedic Surgery | 7835 Grand Blvd, Hobart, IN 46342-6665 | 2015-01-22 |
| 1679903009 | Trihealth Physicians of Indiana, Inc. | Orthopaedic Surgery | 600 Wilson Creek Rd, Suite 310, Lawrenceburg, IN 47025-2751 | 2013-11-21 |
| 1043525009 | Fort Wayne Orthopedics, LLC | Orthopaedic Surgery | 315 W Old Key Dr, Suite 140, Peru, IN 46970-9058 | 2010-08-16 |
| Find all providers with the same taxonomy | ||||
| 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.