Organization Active NPI

Mishawaka Osteopathic Clinic

  • Family Medicine Physician
  • Mishawaka, IN
National Provider Identifier
1336271253
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02000433 Issued in IN
Legal business name
MISHAWAKA OSTEOPATHIC CLINIC
Practice address
1207 Lincoln Way West
Mishawaka, IN 46544
Phone
(574) 255-4733
Fax
(574) 255-4464
NPI assigned
Mar 9, 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. Max E Helman, DO
Title
Owner
Phone
(574) 255-4733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 02000433 IN Primary

Addresses

Primary practice location

1207 Lincoln Way West
Mishawaka, IN 46544

Mailing address

1207 Lincoln Way West
Mishawaka, IN 46544
Phone (574) 255-4733

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
15D0356825Mishawaka Osteopathic Clinic1207 Lincoln Way West, Mishawaka, IN 46544Certificate of waiverOct 23, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336271253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 LINCOLN WAY WEST",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "46544",
            "telephone_number": "574-255-4733",
            "fax_number": "574-255-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 LINCOLN WAY WEST",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "46544",
            "telephone_number": "574-255-4733",
            "fax_number": "574-255-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISHAWAKA OSTEOPATHIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HELMAN",
        "authorized_official_first_name": "MAX",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-255-4733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02000433",
            "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.
  • 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.