NPIMap

Organization Active NPI

Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • Family Medicine Physician
  • Mishawaka, IN
National Provider Identifier
1144580150
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAINT JOSEPH REGIONAL MEDICAL CENTER-SOUTH BEND CAMPUS, INC.
Practice address
611 E Douglas Rd, Ste 406
Family Medicine Faculty Physicians
Mishawaka, IN 46545-1468
Phone
(574) 335-6580
Fax
(574) 335-0818
NPI assigned
May 23, 2012
Organization subpart
Yes
Parent organization
TRINITY HEALTH CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Authorized official

Name
Christopher James Karam
Title
President
Phone
(574) 335-5000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Maternal & Fetal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VM0101X

Addresses

Primary practice location

611 E Douglas Rd, Ste 406
Family Medicine Faculty Physicians
Mishawaka, IN 46545-1468

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
CC0460OtherINRAILROAD MEDICARE
100382210CMedicaidIN

Other names 1

  • Family Medicine Faculty Physicians Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

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
This NPI is an additional NPI on the enrollment
Practice locations: Mishawaka, IN; South Bend, IN

Other NPIs on the same Medicare enrollment 5

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2323536Family Medicine Faculty Physicians611 E Douglas Rd Ste 406, Mishawaka, IN 46545Provider-performed microscopyMay 7, 2027

National Provider Directory

National Provider Directory
Tax ID family
St Josephs Med Ctr8 organizations share this tax ID, including this one
Part of
Trinity Health Academic Internal Medicine-Northwest Livonia

Other organizations with this tax ID 7

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

Locations

12563 State Road 23
Granger, IN 46530
Phone (574) 277-2090

611 E Douglas Rd
Ste 101
Mishawaka, IN 46545
Phone (574) 335-6800

707 Cedar St
Ste 200
South Bend, IN 46617
Phone (574) 237-1328

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5ac0007d-0893-4627-b11f-857c06d27ab1/
  • FHIR API: https://fhir-myrecord.cerner.com/r4/781d290a-0fb7-4574-b825-dd38fe495caa/

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773014400000",
    "number": "1144580150",
    "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": "611 E DOUGLAS RD, STE 406",
            "address_2": "FAMILY MEDICINE FACULTY PHYSICIANS",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451468",
            "telephone_number": "574-335-6580",
            "fax_number": "574-335-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT JOSEPH REGIONAL MEDICAL CENTER-SOUTH BEND CAMPUS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRINITY HEALTH CORPORATION",
        "enumeration_date": "2012-05-23",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A",
        "authorized_official_last_name": "KARAM",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-335-5000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC0460",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100382210C",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Family Medicine Faculty Physicians",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Medicine Faculty Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.