Michiana Concierge Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MICHIANA CONCIERGE FAMILY MEDICINE

Practice address

1217 W Plymouth St
Bremen, IN 46506-1930

Phone

(574) 546-0654

Fax

(888) 815-1434

NPI assigned

Nov 14, 2022

Last updated

Jan 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Graciela Jimenez-Martinez, NURSE PRACTITIONERNPI 1447737002

Title

Owner

Phone

(574) 546-0654

Specialties & licenses 1

Addresses

Locations

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.

• Graciela Jimenez-Martinez, NP

  • Family Nurse Practitioner
  • Bremen, IN
  • NPI 1447737002

  Registered Nurse

  NPD Authorized official

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674777600000",
    "number": "1346958998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 W PLYMOUTH ST",
            "city": "BREMEN",
            "state": "IN",
            "postal_code": "465061930",
            "telephone_number": "574-546-0654",
            "fax_number": "888-815-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 W PLYMOUTH ST",
            "city": "BREMEN",
            "state": "IN",
            "postal_code": "465061930",
            "telephone_number": "574-546-0654",
            "fax_number": "888-815-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIANA CONCIERGE FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ-MARTINEZ",
        "authorized_official_first_name": "GRACIELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-546-0654",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Bremen, IN
• Providers in Bremen, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; 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.