Active NPI
Kearn David Hinchman, DO
- Psychiatry Physician
- South Bend, IN
National Provider Identifier
1134206576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 02001423
- Practice address
- 53779 Generations Drive
Suite 1
South Bend, IN 46635 - Phone
- (574) 258-6316
- Fax
- (574) 258-6307
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | H1441 | TX | |
| Psychiatry Physician | 2084P0800X | 02001423 | IN | Primary |
Addresses
Primary practice location
53779 Generations Drive
Suite 1
South Bend, IN 46635
Mailing address
11042 Birch Lake Dr
South Bend, IN 46635
Phone (574) 258-6316
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 31, 2013 through Oct 31, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H1441 | TX | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1134206576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11042 BIRCH LAKE DR",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "46635",
"telephone_number": "574-258-6316",
"fax_number": "574-258-6307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53779 GENERATIONS DRIVE",
"address_2": "SUITE 1",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "46635",
"telephone_number": "574-258-6316",
"fax_number": "574-258-6307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HINCHMAN",
"first_name": "KEARN",
"middle_name": "DAVID",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "H1441",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IN",
"license": "02001423",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.