Allied Physicians of Michiana, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

ALLIED PHYSICIANS OF MICHIANA, LLC

Practice address

6301 University Commons
Suite 320
South Bend, IN 46635-1571

Phone

(574) 271-7337

NPI assigned

Feb 3, 2010

Organization subpart

Yes

Parent organization

ALLIED PHYSICIANS OF MICHIANA, LLCAs reported in NPPES

Name

Shery Roussarie

Title

Ceo

Phone

(574) 251-2100

Part of

Allied Physicians of Michiana LLC

• Pediatric Associates of Michiana Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 1, 2014.

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406851200000",
    "number": "1114259074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 UNIVERSITY COMMONS",
            "address_2": "SUITE 230",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351571",
            "telephone_number": "574-251-2100",
            "fax_number": "574-251-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 UNIVERSITY COMMONS",
            "address_2": "SUITE 320",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351571",
            "telephone_number": "574-271-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIED PHYSICIANS OF MICHIANA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALLIED PHYSICIANS OF MICHIANA, LLC",
        "enumeration_date": "2010-02-03",
        "last_updated": "2014-08-01",
        "status": "A",
        "authorized_official_last_name": "ROUSSARIE",
        "authorized_official_first_name": "SHERY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "574-251-2100"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200962980K",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Associates of Michiana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Allied Hearing Clinic LLC
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• Allied Physicians of Michiana
• Allied Physicians of Michiana, LLC
• Allied Physicians of Michiana, LLC
• Allied Physicians of Michiana, LLC
• Allied Physicians of Michiana, LLC
• Allied Physicians of Michiana, LLC
• Allied Physicians of Michiana, LLC

• All providers in South Bend, IN
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.