Organization Active NPI

Sir Care, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • South Bend, IN
National Provider Identifier
1295851335
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
01021580A Issued in IN
Legal business name
SIR CARE, LLC
Practice address
18444 Madison Rd
South Bend, IN 46614-9799
Phone
(574) 291-2273
Fax
(574) 291-6774
NPI assigned
Mar 21, 2007
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. Harry J Stoller, MD
Title
Partner
Phone
(574) 291-2273

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207QG0300X 01021580A IN Primary

Addresses

Primary practice location

18444 Madison Rd
South Bend, IN 46614-9799

Mailing address

18444 Madison Rd
South Bend, IN 46614-9799
Phone (574) 291-2273

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295851335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 MADISON RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466149799",
            "telephone_number": "574-291-2273",
            "fax_number": "574-291-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18444 MADISON RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466149799",
            "telephone_number": "574-291-2273",
            "fax_number": "574-291-6774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIR CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STOLLER",
        "authorized_official_first_name": "HARRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "574-291-2273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IN",
            "license": "01021580A",
            "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 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.