NPIMap

Organization Active NPI

Marybeth F McClure DO

  • Pediatrics Physician
  • Mishawaka, IN
National Provider Identifier
1245372739
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
02001001A Issued in IN
Legal business name
MARYBETH F MCCLURE DO
Practice address
1411 Lincoln Way W
Mishawaka, IN 46544-1626
Phone
(574) 259-5666
NPI assigned
Feb 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Marybeth F McClure, DONPI 1306802681
Title
President
Phone
(574) 259-5666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 02001001A IN Primary

Addresses

Primary practice location

1411 Lincoln Way W
Mishawaka, IN 46544-1626

Mailing address

1411 Lincoln Way W
Mishawaka, IN 46544-1626
Phone (574) 259-5666

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245372739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 LINCOLN WAY W",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465441626",
            "telephone_number": "574-259-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 LINCOLN WAY W",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465441626",
            "telephone_number": "574-259-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYBETH F MCCLURE DO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCLURE",
        "authorized_official_first_name": "MARYBETH",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-259-5666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "02001001A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.