PEDIATRIC CARDIOLOGY OF MICHIANA, PC (NPI# 1891816559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891816559 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC CARDIOLOGY OF MICHIANA, PC |
| Practice Address |
707 N Michigan St Suite 316 South Bend IN 46601-1067 |
| Practice Telephone | 5742323325 |
| Practice Fax Number | 5742323358 |
| Mailing Telephone | 5742323325 |
| Mailing Fax Number | 5742323358 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2008-06-17 |
| Authorized Official Name | MRS. STACY SPECKHARD (OFFICE MANAGER) |
| Authorized Official Telephone | 5742323325 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
01034696A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CIGNA | 1761550 | 01 | |
| AETNA | 4564274 | 01 | |
| IN | 100475760A | 05 | |
| IN | BLUE CROSS BLUE SHIELD IN | 000000330797001 | 01 |
| Street Address |
707 N MICHIGAN ST SUITE 316 |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46601-1067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619971488 | Thomas Edward Capannari | Pediatrics | 707 N Michigan St, Ste 316, South Bend, IN 46601 | 2005-06-09 |
| 1588205231 | Patrick Murathimi Mutugu | Registered Nurse | 707 N Michigan St, South Bend, IN 46601-1067 | 2019-10-03 |
| 1952969115 | Caitlin Casey | Student in an Organized Health Care Education/Training Program | 707 N Michigan St, South Bend, IN 46601-1067 | 2019-06-03 |
| 1033520101 | Oluyinka Grace Osunnuga | Nurse Practitioner | 707 N Michigan St, Suite 400, South Bend, IN 46601-1067 | 2014-05-12 |
| 1003172719 | Beth Ann Hayden | Nurse Practitioner | 707 N Michigan St, Ste 400, South Bend, IN 46601-1067 | 2012-04-06 |
| 1447520291 | Advanced Center for Cardiothoracic Surgery LLC | Clinic/Center | 707 N Michigan St, 503, South Bend, IN 46601-1067 | 2012-01-11 |
| 1679707012 | Narendra Pratap Singh | Psychiatry & Neurology | 707 N Michigan St, Suite 400, South Bend, IN 46601-1067 | 2009-05-13 |
| 1275705691 | Jagadeesh Reddy | Psychiatry & Neurology | 707 N Michigan St, Ste 400, South Bend, IN 46601-1067 | 2008-03-26 |
| 1457536336 | Cardiothoracic Surgery, P.C. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 707 N Michigan St, Suite 501, South Bend, IN 46601-1067 | 2008-01-09 |
| 1508080714 | Duane D Flaig | Nurse Practitioner | 707 N Michigan St, Ste 400, South Bend, IN 46601-1067 | 2007-04-12 |
| Find all providers in the same location | ||||
| 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 | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417266818 | Gabriel Paris | Pediatrics | 707 N Michigan St Ste 316, South Bend, IN 46601-1070 | 2010-10-02 |
| 1619971488 | Thomas Edward Capannari | Pediatrics | 707 N Michigan St, Ste 316, South Bend, IN 46601 | 2005-06-09 |
| 1396088787 | Erin K. Davis | Pediatrics | 707 N Michigan St Ste 316, South Bend, IN 46601-1070 | 2013-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114257052 | Children's Heart Care Clinic LLC | Pediatrics | 14328 Waterway Blvd, Fortville, IN 46040-9455 | 2009-12-26 |
| 1619402005 | Leon Frank Przybylowski IIi | Pediatrics | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2017-04-24 |
| 1194160804 | Ryan M. Serrano | Pediatrics | 705 Riley Hospital Dr, Ri 1134, Indianapolis, IN 46202-5109 | 2013-05-08 |
| 1366701690 | Nicholas Benjamin Zaban | Pediatrics | 705 Riley Hospital Dr, Suite Rr 127, Indianapolis, IN 46202-5109 | 2012-05-07 |
| 1114293024 | Andrew Lyle Rodenbarger | Pediatrics | 705 Riley Hospital Dr, Rr 127, Indianapolis, IN 46202-5109 | 2012-03-25 |
| 1184903106 | Poonam M Puranik | Pediatrics | 705 Riley Hospital Dr, Ri 1134, Indianapolis, IN 46202-5109 | 2011-08-08 |
| 1669780029 | St Mary's Ohio Valley Heart Care, LLC | Pediatrics | 901 Saint Marys Dr, Ste 300, Evansville, IN 47714-0520 | 2010-09-20 |
| 1699928739 | Benjamin John Landis | Pediatrics | 705 Riley Hospital Dr, Rr 127, Indianapolis, IN 46202-5109 | 2008-11-03 |
| 1073779641 | Jyoti Kandlikar Patel | Pediatrics | 705 Riley Hospital Dr, Rr 127, Indianapolis, IN 46202-5109 | 2008-08-04 |
| 1528226784 | John Jerry Parent | Pediatrics | 705 Riley Hospital Dr, Ri 1134, Indianapolis, IN 46202-5109 | 2008-05-23 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46601 |
Please comment or provide details below to improve the information on PEDIATRIC CARDIOLOGY OF MICHIANA, PC.
| 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.