CYNTHIA SUSAN FODNESS (NPI# 1184690786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1184690786 |
Entity Type | Individual |
Full Name | CYNTHIA SUSAN FODNESS |
Credential | CNS |
Practice Address |
403 E Madison St South Bend IN 46617-2322 |
Mailing Address |
26164 Twin Lakes Trl South Bend IN 46628-9537 |
Practice Telephone | 5742340061 |
Practice Fax Number | 5742831209 |
Mailing Telephone | 5742738543 |
Mailing Fax Number | 5742831208 |
Enumeration Date | 2006-02-24 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | X |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
28123166A | IN | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
403 E MADISON ST |
City | SOUTH BEND |
State | IN |
Zip Code | 46617-2322 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164497962 | Phillip Coffey | Social Worker | 403 E Madison St, South Bend, IN 46617-2322 | 2006-02-23 |
1134534456 | Memorial Hospital of South Bend, Inc | General Acute Care Hospital | 403 E Madison St, South Bend, IN 46617-2322 | 2014-06-25 |
1225310402 | Susan K Henderson | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2011-09-14 |
1154633550 | Meladie A Langham | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2010-07-14 |
1497067896 | Kami S Brenneman | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2010-07-14 |
1396064309 | Casandra Mcgrew | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2010-06-01 |
1124347133 | Amanda Jardine | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2010-06-01 |
1104141985 | Aaron T Gray | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2010-04-05 |
1346579679 | Linda S Hoppel | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2009-12-16 |
1235468570 | Michelle M Peters | Social Worker | 403 E Madison St, South Bend, IN 46617-2322 | 2009-12-16 |
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 | 364SP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Clinical Nurse Specialist |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639279177 | Gerald C Lewis | Clinical Nurse Specialist | 707 N Michigan St, Ste 400, South Bend, IN 46601-1067 | 2006-09-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053650887 | Gerald Lewis Inc. | Clinical Nurse Specialist | 1150 Eastport Centre Dr, Suite D, Valparaiso, IN 46383-8427 | 2013-02-14 |
1437497864 | Abidemi Mary Ajuwon | Clinical Nurse Specialist | 3420 Cinnabar St, West Lafayette, IN 47906-7208 | 2013-01-18 |
1952603664 | Tara Elizabeth Gavardinas | Clinical Nurse Specialist | The Indiana Clinic, 340 W. 10th Street, Fs 5100, Indianapolis, IN 46202 | 2010-12-01 |
1407014327 | Regina Dawn Haight | Clinical Nurse Specialist | 1701 N Capitol Ave, C-3, Indianapolis, IN 46202-1203 | 2008-05-28 |
1073780102 | Deborah Lynn May | Clinical Nurse Specialist | 10748 Weston Dr, Carmel, IN 46032-9319 | 2008-05-08 |
1245403419 | Carol Agnes Essenmacher | Clinical Nurse Specialist | 8075 N Shadeland Ave Ste 350, Indianapolis, IN 46250-2693 | 2008-04-09 |
1508041716 | Elisabeth K Degenhardt | Clinical Nurse Specialist | 5230 E Stop 11 Rd Ste 300, Indianapolis, IN 46237-6401 | 2008-01-07 |
1306999131 | Kathleen R Lynch Lewis | Clinical Nurse Specialist | 281 Bielby Rd, Lawrenceburg, IN 47025-1055 | 2007-01-18 |
1831207000 | Frances Lucille Miller | Clinical Nurse Specialist | 145 Green Meadows Drive, Greenfield, IN 46140-4001 | 2006-08-28 |
1558308841 | Jennifer G Sims | Clinical Nurse Specialist | 1481 W 10th St # C-5085, Richard L Roudebush Va Medical Center, Indianapolis, IN 46202-2803 | 2006-06-02 |
Find all providers with the same taxonomy |
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.