JON BERNARD KUBLEY (NPI# 1124067830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124067830 |
| Entity Type | Individual |
| Full Name | JON BERNARD KUBLEY |
| Credential | M.D. |
| Practice Address |
1919 Lake Ave Suite 104 Plymouth IN 46563-7830 |
| Mailing Address |
Po Box 6309 South Bend IN 46660-6309 |
| Practice Telephone | 5749412929 |
| Practice Fax Number | 5749413008 |
| Mailing Telephone | 5744726700 |
| Mailing Fax Number | 5744726746 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2008-05-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 01028632 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100173520A | 05 | |
| IN | FEDERAL BLACK LUNG | 021236800 | 01 |
| Street Address |
1919 LAKE AVE SUITE 104 |
| City | PLYMOUTH |
| State | IN |
| Zip Code | 46563-7830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871548438 | Samuel B Vanlandingham | Surgery | 1919 Lake Ave, Suite 102, Plymouth, IN 46563-7830 | 2006-05-23 |
| 1225531213 | Primmer Logan Zook | Specialist/Technologist | 1919 Lake Ave, Plymouth, IN 46563-7830 | 2018-03-15 |
| 1134622129 | Jordan Kelly Weitzell | Specialist/Technologist | 1919 Lake Ave, Plymouth, IN 46563-7830 | 2018-03-15 |
| 1942664008 | James Warren Dammon Jr. | Surgery | 1919 Lake Ave, Suite 102, Plymouth, IN 46563-7830 | 2016-04-05 |
| 1902200298 | Allied Physicians of Michiana, LLC | Durable Medical Equipment & Medical Supplies | 1919 Lake Ave, Suite 107b, Plymouth, IN 46563-7830 | 2014-10-15 |
| 1033439989 | Rushabh Anilkumar Shah | Pediatrics | 1919 Lake Ave, Suite 110, Plymouth, IN 46563-7830 | 2010-06-02 |
| 1033388558 | Edison Lakes Urology Plymouth Office | Urology | 1919 Lake Ave, Suite 109, Plymouth, IN 46563-7830 | 2008-02-28 |
| 1740366657 | Ryan Joseph Carroll | Specialist/Technologist | 1919 Lake Ave, Suite 111, Plymouth, IN 46563-7830 | 2006-10-31 |
| 1255439022 | Diagnostic Medicine PC | Internal Medicine | 1919 Lake Ave, Ste 108, Plymouth, IN 46563-7830 | 2006-09-20 |
| 1881703809 | Brian L Piazza | Surgery | 1919 Lake Ave, Suite 102, Plymouth, IN 46563-7830 | 2006-08-30 |
| Find all providers in the same location | ||||
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265996219 | Housecall Physicians, Inc | Family Medicine | 31 Home Depot Drive, Suite 283, Plymouth, MA 02360 | 2019-01-24 |
| 1215445994 | Jefferson Community Health Center Inc | Family Medicine | 316 N Madison Ave, Ste 200, Plymouth, NE 68424-4110 | 2018-01-17 |
| 1124551833 | Xpress Urgent Care PC | Family Medicine | 49237 Fox Dr N, Plymouth, MI 48170-5205 | 2017-04-10 |
| 1952853525 | Ann Curoe | Family Medicine | 10835 38th Pl N, Plymouth, MN 55441-1409 | 2016-10-31 |
| 1639429558 | Carol Elizabeth Ness | Family Medicine | 1145 Shenandoah Ln N, Plymouth, MN 55447-3201 | 2012-09-18 |
| 1881953461 | Ronald Carl Skoogberg | Family Medicine | 3025 Harbor Lane, Suite 101, Plymouth, MN 55447-5141 | 2012-05-16 |
| 1093955700 | Soliman Home Visiting Physicians Pllc | Family Medicine | 12173 Chandler Dr, Plymouth, MI 48170-3193 | 2009-02-20 |
| 1457508079 | Chaitra Channappa | Family Medicine | 31 Home Depot Dr Ste 283, Plymouth, MA 02360-2669 | 2008-08-26 |
| 1730365388 | Milton Delin Westberg | Family Medicine | 1010 Wilson St, Plymouth, NC 27962-9185 | 2008-01-14 |
| 1194849398 | Michael A Martella | Family Medicine | 515 E Mill Street, Plymouth, WI 53073-1807 | 2007-03-16 |
| 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.