OTORHINOLARYNGOLOGY, INC (NPI# 1942246822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942246822 |
| Entity Type | Organization |
| Organization Name | OTORHINOLARYNGOLOGY, INC |
| Practice Address |
621 Memorial Dr Suite 402 South Bend IN 46601-1063 |
| Mailing Address |
Po Box 1916 South Bend IN 46634-1916 |
| Practice Telephone | 5742324800 |
| Mailing Telephone | 5742324800 |
| Mailing Fax Number | 5742821018 |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2009-10-29 |
| Authorized Official Name | DANIEL W KLETZING (PRESIDENT) |
| Authorized Official Telephone | 5742324800 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | IN | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100465500 | 05 | |
| IN | FACIAL PLASTIC TAXONOMY | 207YX0905X | 01 |
| IN | OTO TAXONOMY | 207Y00000X | 01 |
| IN | TAX IDENTIFICATION | 35157729 | 01 |
| IN | ALLERGY TAXONOMY 1 | 207YX0602Y | 01 |
| Street Address |
621 MEMORIAL DR SUITE 402 |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46601-1063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003818212 | John L Jenkins | Specialist | 621 Memorial Dr, Ste 502, South Bend, IN 46601-1075 | 2005-06-01 |
| 1447783188 | Khonnah Weithers | Nurse Practitioner | 621 Memorial Dr, Suite 512, South Bend, IN 46601-1063 | 2017-04-10 |
| 1619388717 | Sarah Ann Holewczynski | Registered Nurse | 621 Memorial Dr, Ste 617, South Bend, IN 46601-1063 | 2014-05-12 |
| 1518302264 | Beacon Medical Group, Inc. | Nurse Practitioner | 621 Memorial Dr, Suite 602, South Bend, IN 46601-1063 | 2013-05-08 |
| 1255620985 | David L. Clayton Md Inc | Family Medicine | 621 Memorial Dr, Suite 624, South Bend, IN 46601-1063 | 2011-04-04 |
| 1477873644 | Rebecca M Castro | Nurse Practitioner | 621 Memorial Dr, Ste 502, South Bend, IN 46601-1063 | 2010-06-10 |
| 1508191768 | Allied Physicians of Michiana, LLC | Surgery | 621 Memorial Dr, Suite 302, South Bend, IN 46601-1063 | 2009-10-06 |
| 1841434354 | Kelly Elizabeth Mortell | Radiology | 621 Memorial Dr, Ste 312, South Bend, IN 46601-1063 | 2009-04-28 |
| 1659543643 | William Hanley | Nurse Practitioner | 621 Memorial Dr, Suite 502, South Bend, IN 46601-1063 | 2008-03-31 |
| 1134262595 | North Central Neurology, LLC | Psychiatry & Neurology | 621 Memorial Dr, Suite 624, South Bend, IN 46601-1063 | 2007-02-15 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871922799 | Northern Indiana Orthopaedic Specialty Associates, PC | Specialist | 6301 University Commons Ste 420, South Bend, IN 46635-1416 | 2013-11-01 |
| 1962642306 | Lisa James | Specialist | 60660 Gentle Run Ct, South Bend, IN 46614-5185 | 2009-02-25 |
| 1497928055 | Amy Dennise Woodard | Specialist | 606 Robert Bush Drive, Suite 1, South Bend, WA 98586-0384 | 2008-04-03 |
| 1497842033 | Worksport Rehabilitation Service | Specialist | 411 E Ireland Rd Ste 400, South Bend, IN 46614-2681 | 2006-10-06 |
| 1104834670 | Renee L Hensley | Specialist | 411 E Ireland Rd, Ste 400, South Bend, IN 46614-2680 | 2006-08-03 |
| 1649225095 | Allied Hematology Oncology Associates LLC | Specialist | 6319 State Road 23, South Bend, IN 46635-1475 | 2006-05-24 |
| 1528013372 | Uthman Cavallo | Specialist | 53800 Generations Dr, South Bend, IN 46635 | 2006-05-23 |
| 1578547402 | Ismail Al-ani | Specialist | 621 Memorial Drive, Suite512, South Bend, IN 46601-1074 | 2005-12-05 |
| 1003818212 | John L Jenkins | Specialist | 621 Memorial Dr, Ste 502, South Bend, IN 46601-1075 | 2005-06-01 |
| 1205473451 | Integrative Care Partners LLC | Specialist | 211 N Eddy St, South Bend, IN 46617-2808 | 2019-12-06 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46601 |
Please comment or provide details below to improve the information on OTORHINOLARYNGOLOGY, INC.
| 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.