JOHN BENJAMIN BACCUS III (NPI# 1508831157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508831157 |
| Entity Type | Individual |
| Full Name | JOHN BENJAMIN BACCUS III |
| Credential | M.D. |
| Practice Address |
5314 Lincolnway E Mishawaka IN 46544-4249 |
| Mailing Address |
710 N Niles Ave South Bend IN 46617-1924 |
| Practice Telephone | 5742569032 |
| Practice Fax Number | 5742569049 |
| Mailing Telephone | 5746471610 |
| Mailing Fax Number | 5742376069 |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2017-11-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
01072136A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201141150 | 05 | |
| IN | BCBS BMG | 000000806974 | 01 |
| IN | MEDICARE PTAN | 565800024 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093138265 | John Alan Baccus | Clinical Medical Laboratory | 5000 El Dorado Parkway, Suite 150, Box 312, Frisco, TX 75033 | 2014-01-24 |
| Street Address |
5314 LINCOLNWAY E |
| City | MISHAWAKA |
| State | IN |
| Zip Code | 46544-4249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477552313 | Terrance Neil Tanner | Social Worker | 5314 Lincolnway E, Mishawaka, IN 46544-4249 | 2005-07-20 |
| 1689950867 | Elkhart Clinic, LLC | Clinic/Center | 5314 Lincolnway E, Mishawaka, IN 46544-4249 | 2011-11-01 |
| 1518256098 | Kathryn Anne Kenney | Psychiatry & Neurology | 5314 Lincolnway E, Mishawaka, IN 46544-4249 | 2011-04-05 |
| 1093888430 | Heidi A Collins | Physical Medicine & Rehabilitation | 5314 Lincolnway E, Mishawaka, IN 46544-4249 | 2006-11-15 |
| 1275550899 | Beacon Medical Group, Inc. | Physical Medicine & Rehabilitation | 5314 Lincolnway E, Mishawaka, IN 46544-4249 | 2006-07-17 |
| 1992752018 | Chiedu Charles Onunkwo | Internal Medicine | 5314 Lincolnway E, Mishawaka, IN 46544-4249 | 2006-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692676 | Lynnette Markowicz | Occupational Therapist | 1540 S. Logan St, Mishawaka, IN 46544 | 2020-09-08 |
| 1902429822 | Hellenic Senior Living of Mishawaka LLC | Assisted Living Facility | 1540 S. Logan Street, Mishawaka, IN 46544 | 2020-05-27 |
| 1184275422 | Lorrajean A Gleva | Technician | 203 Eastgate Circle, Mishawaka, IN 46544 | 2019-09-27 |
| 1376072785 | Aims, LLC | Psychologist | 1113 Mossy Lane, Mishawaka, IN 46544 | 2017-06-08 |
| 1760835912 | Ophelia Ansari | Nurse Practitioner | 4501 Linconway East, Mishawaka, IN 46544 | 2016-07-22 |
| 1598153355 | Hearing Aid Service | Hearing Instrument Specialist | 3718 Lincolnway E, Mishawaka, IN 46544 | 2015-01-02 |
| 1437587953 | Christopher Ryan Hazel | Dentist | 544 Lincolnway West, Mishawaka, IN 46544 | 2013-10-18 |
| 1699015941 | Frank Walerko | Urology | 809 Bittersweet Cove Drive, Mishawaka, IN 46544 | 2013-02-25 |
| 1023251337 | Josephine Schimizzi | Family Medicine | 1505 South Spring Street, Mishawaka, IN 46544 | 2009-04-16 |
| 1881831147 | Walgreen Co | Pharmacy | 4620 Lincolnway E, Mishawaka, IN 46544 | 2009-01-08 |
| Find all providers in zip 46544 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447212006 | Ralph F Carbone Jr. | Anesthesiology | 212 W Edison Rd Ste F, Mishawaka, IN 46545-8301 | 2006-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902429509 | Apollo Pain Center, LLC | Anesthesiology | 1458 S Jackson St, Frankfort, IN 46041-3315 | 2020-05-19 |
| 1215497763 | Hendricks County Hospital | Anesthesiology | 8244 E Us Highway 36 Ste 150, Avon, IN 46123-5526 | 2019-03-21 |
| 1881081552 | Aapolo Spine and Pain Management Center | Anesthesiology | 4215 N 210 E, Marion, IN 46952-6634 | 2015-04-21 |
| 1629488002 | Shaan Khan | Anesthesiology | 500 Legacy Plz W, La Porte, IN 46350-5254 | 2014-05-06 |
| 1578800561 | Complete Pain Care LLC | Anesthesiology | 10744 E Us Highway 36, Avon, IN 46123-7982 | 2013-01-10 |
| 1710282439 | Unity Healthcare, LLC | Anesthesiology | 3738 Landmark Drive, Suite A, Lafayette, IN 47905-6633 | 2011-01-12 |
| 1073831160 | Shahbaz Qavi | Anesthesiology | 107 S Washington St Ste C, Kokomo, IN 46901-4601 | 2010-05-13 |
| 1750522660 | Nicolaus D Winters | Anesthesiology | 7145 E Virginia St Ste 5000, Evansville, IN 47715-9143 | 2009-03-23 |
| 1245449172 | Charles S Lindzy | Anesthesiology | 14104 Peddlers Ford, Fort Wayne, IN 46814 | 2007-05-21 |
| 1669500229 | Advanced Pain Management Surgery,inc | Anesthesiology | 4010 W Goeller Blvd, Suite C, Columbus, IN 47201-8892 | 2007-03-02 |
| Find all providers with the same taxonomy | ||||
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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.