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SAINT JOSEPH REGIONAL MEDICAL CENTER PLYMOUTH CAMPUS INC NPI 1538585187


NPI Information

NPI: 1538585187
Provider Name: SAINT JOSEPH REGIONAL MEDICAL CENTER PLYMOUTH CAMPUS, INC

Doing Business As: SAINT JOSEPH HEALTH CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 15D2199682

Address:
1919 LAKE AVE STE 102B
PLYMOUTH, IN
ZIP 46563
Phone: (574) 335-6800
Get Directions

SAINT JOSEPH REGIONAL MEDICAL CENTER PLYMOUTH CAMPUS, INC is a family medicine in Plymouth, IN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SAINT JOSEPH REGIONAL MEDICAL CENTER PLYMOUTH CAMPUS, INC NPI is 1538585187. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Saint Joseph Health Center.

The provider's business location address is:

1919 LAKE AVE STE 102B
PLYMOUTH, IN
ZIP 46563-830
Phone: (574) 335-6800
Fax: (574) 948-5480

The provider's authorized official is Rob Sink .
The authorized official title is Vice President Of Finance and has the following contact phone number (574) 335-5000.

The CLIA number assigned to this NPI record is 15D2199682 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/6/2014 and was last updated on 10/4/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QS0010XFamily MedicineSports MedicineNo
2207R00000XInternal MedicineNo
3208000000XPediatricsNo
42081S0010XPhysical Medicine & RehabilitationSports MedicineNo
5213E00000XPodiatristNo
6213ES0103XPodiatristFoot & Ankle SurgeryNo
7363LF0000XNurse PractitionerFamilyNo
8207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1201216910AMEDICAIDINDIANA
2000000875287OTHERINDIANABCBS
3300036720MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.