JEFFREY MICHAEL FENIMORE (NPI# 1295362994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295362994 |
| Entity Type | Individual |
| Full Name | JEFFREY MICHAEL FENIMORE |
| Credential | RPH |
| Practice Address |
4526 W Western Ave South Bend IN 46619-2302 |
| Practice Telephone | 5742880471 |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2020-03-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
2602798A | IN | Pharmacy Service Providers |
| Street Address |
4526 W WESTERN AVE |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46619-2302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396818811 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 4526 W Western Ave, South Bend, IN 46619-2302 | 2006-11-15 |
| 1023632114 | Dayna Gumm | Student in an Organized Health Care Education/Training Program | 4526 W Western Ave, South Bend, IN 46619-2302 | 2020-06-03 |
| 1720627458 | Susan Curry | Pharmacist | 4526 W Western Ave, South Bend, IN 46619-2302 | 2019-12-28 |
| 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 |
| 1942302203 | April Holtgren | Family Medicine | 1901 #b Western Ave, South Bend, IN 46619 | 2006-09-05 |
| 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 |
| Find all providers in zip 46619 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104451798 | Ryan Lipinski | Pharmacist | 615 N Michigan St, South Bend, IN 46601-1033 | 2020-03-04 |
| 1205225059 | Jessica Jeanette Lynton | Pharmacist | 714 N Michigan St, South Bend, IN 46601-1035 | 2015-01-16 |
| 1689966590 | Edward Nicholas Battjes | Pharmacist | 837 Cedar St Ste 100, South Bend, IN 46617-2000 | 2011-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841816766 | Kimberlee Chilcote | Pharmacist | 8275 Allison Pointe Trl Ste 370, Indianapolis, IN 46250-4298 | 2020-06-17 |
| 1700413721 | Damar Pharmacy Services LLC | Pharmacist | 5715 Decatur Blvd, Indianapolis, IN 46241-9561 | 2020-03-27 |
| 1871123562 | Kathy Jo Passereni | Pharmacist | 1541 Tipton St, Seymour, IN 47274 | 2020-01-22 |
| 1811537095 | Marla Ann Carroll | Pharmacist | 815 Highlander Point Drive, Floyds Knobs, IN 47119 | 2020-01-15 |
| 1508404815 | Shelli Ann Bulach | Pharmacist | 1034 Sr 229 North, Batesville, IN 47006 | 2019-12-17 |
| 1235773169 | Amy Epley | Pharmacist | 350 W Columbia St Ste 210, Evansville, IN 47710-1782 | 2019-11-04 |
| 1649767955 | Sean Meador | Pharmacist | 3630 31st Street, Columbus, IN 47203 | 2018-04-23 |
| 1093218489 | Sparkle Box | Pharmacist | 1908 Bluebird Ln, Munster, IN 46321-3429 | 2018-03-13 |
| 1194150490 | Janet Redmond | Pharmacist | 6911 Hillsdale Ct, Indianapolis, IN 46250-2054 | 2013-09-05 |
| 1962751446 | Robert L Plant | Pharmacist | 3602 New Vision Drive, Fort Wayne, IN 46845 | 2012-08-30 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46619 |
Please comment or provide details below to improve the information on JEFFREY MICHAEL FENIMORE.
| 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.