Tara Eugenia Mathis

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Practice address

1657 Commerce Dr Ste 8B
South Bend, IN 46628-1542

Phone

(574) 367-0395

Fax

(844) 894-8398

NPI assigned

Jul 10, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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

• Making a Difference LLC

  • Home Health Agency
  • South Bend, IN
  • NPI 1871321174
  NPD Authorized official

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1346087053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20200 MILLER RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466149432",
            "telephone_number": "574-367-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1657 COMMERCE DR STE 8B",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466281542",
            "telephone_number": "574-367-0395",
            "fax_number": "844-894-8398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 Chapin St",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466012542",
            "country_code": "US",
            "telephone_number": "574-367-0395",
            "fax_number": "844-894-8398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "TARA",
        "middle_name": "EUGENIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61-1857998",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL REVENUE SERVICES",
            "identifier": "61-1857998",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tobin J Mathews, M.D.
• Ashley Mathis, PT, DPT
• John Glenn Mathis, M.D.
• Rachel Elizabeth Mathis, MD
• Ramona Hernandez Mathis, LCSW
• Antoinette Matlock, RBT
• Lee Ann Matson, NURSE PRACTITIONER
• Sharon K Matuszkiewicz Bergemann
• Madison Thelein Matyas
• Patricia Matz, SLP

• Home Health Agency in South Bend, IN
• Providers in South Bend, IN by specialty
• Home Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; 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.