Marybeth Francis McClure, D0

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

02001001 Issued in IN

Practice address

1411 Lincoln Way W
Mishawaka, IN 46544-1626

Phone

(574) 259-5666

NPI assigned

Apr 25, 2006

Last updated

Feb 13, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Marybeth F McClure DO

  • Pediatrics Physician
  • Mishawaka, IN
  • NPI 1245372739
  Authorized official Same address or phone

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1306802681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4755 AMERITECH DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466289120"
        },
        {
            "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": {
        "last_name": "MCCLURE",
        "first_name": "MARYBETH",
        "middle_name": "FRANCIS",
        "credential": "D0",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "02001001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100354880",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beth Johanna McAbee, NP
• Stephanie McAfee, PHARMD, RPH
• Cynthia L McCay, LCSW
• Debra R McClain, M.D.
• Dakota Leigh McClelland
• Andre McCollough, M.D.
• Adalynn Danette McCullough, M.A. CCC-SLP
• Avery Antonio McCully
• Carolyn McDonald, CNM
• Wanda Ann McFadden, LCSW

• Pediatrics Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.