MEMORIAL HEALTH SYSTEM, INC. (NPI# 1346290103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346290103 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HEALTH SYSTEM, INC. |
| Other Organization Name | DEVELOPMENTAL PEDIATRICS |
| Practice Address |
809 N Michigan St South Bend IN 46601-1088 |
| Mailing Address |
710 N Niles Ave South Bend IN 46617-1924 |
| Practice Telephone | 5746477300 |
| Mailing Telephone | 5746471610 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2016-03-09 |
| Authorized Official Name | JEFFREY COSTELLO (VP-CFO) |
| Authorized Official Telephone | 5746473549 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
01060385A | IN | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Developmental Pediatrics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902134521 | Memorial Health System, Inc. | Advanced Practice Midwife | 244 S Olive St, Suite E, South Bend, IN 46619-2100 | 2009-11-19 |
| 1013133487 | Memorial Health System, Inc. | Physical Therapist | 900 I St, La Porte, IN 46350-5533 | 2007-04-17 |
| 1073554994 | Memorial Health System, Inc. | Internal Medicine | 621 Memorial Dr, Suite 608, South Bend, IN 46601-1063 | 2006-06-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Memorial Health System, Inc. | 1400 East Boulder Street, Colorado Springs, CO 80909 |
| Street Address |
809 N MICHIGAN ST |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46601-1088 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447610449 | David Thomas | Hearing Instrument Specialist | 808 S Michigan St., South Bend, IN 46601 | 2016-03-03 |
| 1285072454 | Kevin Francis Cumper | Internal Medicine | 621 Memorial Dr Ste 624, South Bend, IN 46601 | 2013-06-11 |
| 1952605560 | Robert Lusk Bonham | Dentist | 1222 L.w.e., So. Bend, IN 46601 | 2010-12-23 |
| 1649580911 | Daniel Scott Debrule | Psychologist | 211 W. Washington Street, Suite 2311, South Bend, IN 46601 | 2010-10-20 |
| 1528390770 | Luke Alfred White | Internal Medicine | 615 N. Michigan St., Memorial Hospital, C/o Erin Smith, South Bend, IN 46601 | 2010-02-12 |
| 1548497837 | Tmg Home Health Care | Home Health | 108 N Main St #305, South Bend, IN 46601 | 2009-06-15 |
| 1225283039 | Jody L. Hughes | Counselor | 202 S. Michigan Street, Suite 875, South Bend, IN 46601 | 2008-11-20 |
| 1740432574 | Amanda Jayne Quicksall | Social Worker | 611 Lincolnway W, South Bend, IN 46601 | 2008-10-10 |
| 1952565772 | Thomas P Judd | Dentist | 1901 #b Western Avenue, Ihc South Bend, South Bend, IN 46601 | 2008-07-10 |
| 1851590269 | Warren Larry Penrod | Nurse Practitioner | 333 W. Western Ave, South Bend, IN 46601 | 2007-07-16 |
| Find all providers in zip 46601 | ||||
| Taxonomy Code | 2080P0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Developmental – Behavioral Pediatrics |
| A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043868854 | Leslie A Keys | Pediatrics | 1213 Tower Dr, Boonville, IN 47601-2359 | 2019-08-27 |
| 1962763227 | John Harrison Heiligenstein | Pediatrics | 4470 Braedonwood, Indianapolis, IN 46228-3367 | 2012-06-04 |
| 1730241910 | Stacy Elizabeth Doriot | Pediatrics | 1670 W Aimee Ct, Scottsburg, IN 47170-6806 | 2006-12-14 |
| 1346282241 | Robert E Alley | Pediatrics | 60 S Stockwell Rd, Evansville, IN 47714-0247 | 2006-06-12 |
| 1922009786 | Edward B Aull | Pediatrics | 13430 N Meridian St #365, Suite 365, Carmel, IN 46032 | 2005-08-02 |
| 1700437324 | Cortney Trexler | Pediatrics | 2513 W 2nd St, Marion, IN 46952-3241 | 2019-09-25 |
| 1447696703 | Matthew Aaron Miller | Pediatrics | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2013-05-14 |
| 1073834677 | Michelle J. Curtin | Pediatrics | 705 Riley Hospital Dr, Ri 1601, Indianapolis, IN 46202-5109 | 2010-06-17 |
| 1679893580 | Indiana University Health Ball Memorial Physicians, Inc. | Pediatrics | 205 N Tillotson Ave, Suite 102, Muncie, IN 47304-3990 | 2010-06-03 |
| 1902048325 | Jordan Christopher Huskins | Pediatrics | 705 Riley Hospital Dr, Ri 1601, Indianapolis, IN 46202-5109 | 2009-03-31 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46601 |
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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.