NPIMap

Organization Active NPI

Saint Joseph Regional Medical Center-South Bend Campus, Inc

Doing business as Saint Joseph Regional Medical Center-South Bend Campus Inc Mobile Med

  • Mobile Mammography Clinic/Center
  • South Bend, IN
National Provider Identifier
1023844693
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Mammography Clinic/CenterTaxonomy code 261QR0207X
Legal business name
SAINT JOSEPH REGIONAL MEDICAL CENTER-SOUTH BEND CAMPUS, INC
Doing business as
Saint Joseph Regional Medical Center-South Bend Campus Inc Mobile Med
Practice address
234 Chapin St Ste I
South Bend, IN 46601-2571
Phone
(574) 274-4552
Fax
(574) 335-0660
NPI assigned
Sep 11, 2024
Last updated
Jan 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christopher James Karam
Title
RHM President
Phone
(575) 335-5000

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WC1500X
Community Health WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 172V00000X
Mammography Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471M2300X
Multi-Specialty Clinic/Center 261QM1300X
Mobile Mammography Clinic/Center 261QR0207X Primary
Community Health/Public Health Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SC1501X

Addresses

Primary practice location

234 Chapin St Ste I
South Bend, IN 46601-2571

Mailing address

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone (574) 335-8707

Other names 1

  • Saint Joseph Regional Medical Center-South Bend Campus Inc Mobile Med Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031223000724 IN Part B Supplier - Clinic/Group Practice 3476451790 Receives reassigned benefits from 206 practitioners
8 other NPIs on this enrollment
Practice locations: Mishawaka, IN; South Bend, IN

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Saint Joseph Regional M8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

234 Chapin St
Ste 1
South Bend, IN 46601
Phone (574) 335-8250

Practitioners & affiliated clinicians

Practitioners 214

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 214

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1023844693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451469",
            "telephone_number": "574-335-8707",
            "fax_number": "574-335-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 CHAPIN ST STE I",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466012571",
            "telephone_number": "574-274-4552",
            "fax_number": "574-335-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT JOSEPH REGIONAL MEDICAL CENTER-SOUTH BEND CAMPUS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-11",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "KARAM",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "RHM PRESIDENT",
        "authorized_official_telephone_number": "575-335-5000"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471M2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Mammography",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0207X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile Mammography",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "364SC1501X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Community Health/Public Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saint Joseph Regional Medical Center-South Bend Campus Inc Mobile Med",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Saint Joseph Regional Medical Center-South Bend Campus Inc Mobile Med",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.