INDIANA HEALTH CENTERS, INC.


Address: 1901 #b Western Ave, South Bend, IN 46619
Phone: 5742349033

INDIANA HEALTH CENTERS, INC. (NPI# 1174626014) 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) 1174626014
Entity Type Organization
Organization Name INDIANA HEALTH CENTERS, INC.
Other Organization Name INDIANA HEALTH CENTER @ SOUTH BEND
Practice Address 1901 #b Western Ave
South Bend
IN 46619
Mailing Address 8003 Castleway Dr
Indianapolis
IN 46250-1946
Practice Telephone 5742349033
Practice Fax Number 5742349059
Mailing Telephone 3175761335
Mailing Fax Number 3175761339
Enumeration Date 2006-09-06
Last Update Date 2009-12-02
Authorized Official Name DR. TERRANCE J DRAKE (CHIEF MEDICAL OFFICER (CMO))
Authorized Official Telephone 3175761335
Authorized Official Credential M.D., F.A.A.P.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 122300000X Dentist Dental Providers
N 207R00000X Internal Medicine Allopathic & Osteopathic Physicians
N 208000000X Pediatrics Allopathic & Osteopathic Physicians
Y 207Q00000X Family Medicine Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IN 100071250 C 05

Other Provider/Organization Names

Other Name Type Code
Indiana Health Center @ South Bend Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1750595765 Indiana Health Centers, Inc. Public Health or Welfare Tipton County Wic Program, 119 West Washington Street, Tipton, IN 46072 2007-05-09
1114395647 Indiana Health Centers, Inc. Clinic/Center 3118 S Lafountain St, Kokomo, IN 46902-3710 2015-09-15
1134227689 Indiana Health Centers, Inc. Dentist 113 N Chestnut St, Seymour, IN 47274-2176 2006-09-20
1306957311 Indiana Health Centers, Inc. Family Medicine 701 S Main St, South Bend, IN 46601-3000 2006-08-31
1619087624 Indiana Health Centers, Inc. Family Medicine 925 S Nebraska St, Marion, IN 46953-1874 2006-08-30
1811007800 Indiana Health Centers, Inc. Dentist 3118 S Lafountain St, Kokomo, IN 46902-3710 2006-08-30
1669582664 Indiana Health Centers, Inc. Family Medicine 1700 Dividend Dr, Logansport, IN 46947-1572 2006-08-30

Office Location

Street Address 1901 #B WESTERN AVE
City SOUTH BEND
State IN
Zip Code 46619

Providers in the same location

NPI Name Taxonomy Address Enumeration
1942302203 April Holtgren Family Medicine 1901 #b Western Ave, South Bend, IN 46619 2006-09-05

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1578015103 Martin's Super Markets, Inc. Pharmacy 525 S. Mayflower Rd, South Bend, IN 46619 2016-10-31
1124449053 Sandra J Jackson Counselor 4218 Western Ave., South Bend, IN 46619 2013-12-19
1902227911 Patricia Ann Miller Counselor 4218 Western Ave, South Bend, IN 46619 2013-12-17
1740611953 Cynthia G. Finney Counselor 4218 Western Avenue, So Bend, IN 46619 2013-12-13
1437433406 Angela Nicole Zolvinski Pharmacist 4444 W. Western Ave, South Bend, IN 46619 2011-10-07
1871674556 The Health and Hospital Corporation of Marion County Skilled Nursing Facility 4600 W Washington St, South Bend, IN 46619 2006-10-18
1447737002 Graciela Jimenez-martinez Registered Nurse 1901 #b Western Avenue, South Bend, IN 46619 2018-07-25
1821397878 Wright Dream In Home Supportive Care 706 S Sheridan St, South Bend, IN 46619 2011-03-16
1740439223 Scott J. Vanslambrouck Dentist 1901 #b Western Avenue, Ihc South Bend, South Bend, IN 46619 2008-09-09
1295064954 Southwest Central Fire Territory Non-emergency Medical Transport (VAN) 23626 Fillmore Rd, South Bend, IN 46619-1502 2009-12-09
Find all providers in zip 46619

Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285998146 Thomas Larsen Family Medicine 4440 Portage Ave, South Bend, IN 46628-9570 2012-06-26
1316180318 Paul Angelo Carl Macri Family Medicine 2012 Cedar St, South Bend, IN 46617-2542 2009-04-07
1285818591 Jaroslaw Kuna Family Medicine 320 S Saint Joseph St Ste 300, South Bend, IN 46601-2308 2007-12-21
1013117472 Ronald E Grow Inc Family Medicine 810 W Indiana Ave, South Bend, IN 46613-1828 2007-07-23
1124241211 Trixy Franke Family Medicine 837 E. Cedar St., Ste 100, South Bend, IN 46617 2007-04-10
1225185739 Michael J. O'connell D.o. Inc Family Medicine 17960 Cleveland Road, South Bend, IN 46635 2007-01-05
1679620579 Mark R. Neff Family Medicine 804 Lancaster Dr, South Bend, IN 46614-2020 2007-01-04
1437216587 David Wood Baxter Family Medicine 115 E Cripe St, South Bend, IN 46637-3402 2007-01-01
1477635944 Alan Snell Family Medicine 837 East Cedar St., Ste 100, South Bend, IN 46617 2006-10-20
1437240694 Brian Anthony Jacobs Family Medicine 610 N Michigan Street, Suite 308, South Bend, IN 46601 2006-09-27
Find all providers in SOUTH BEND

Competitor

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City SOUTH BEND
Zip Code 46619

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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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