Active NPI
John F Zwerneman, MD
- Psychiatry Physician
- South Bend, IN
National Provider Identifier
1376510610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 01043307
- Practice address
- 403 E Madison St
South Bend, IN 46617-2322 - Phone
- (574) 234-0061
- Fax
- (574) 283-1209
- NPI assigned
- Mar 7, 2006
- Last updated
- Nov 2, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 01043307 | IN | Primary |
Addresses
Primary practice location
403 E Madison St
South Bend, IN 46617-2322
Mailing address
15945 Preswick LN
Granger, IN 46530-6518
Phone (574) 273-1769
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200062340A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01043307 | IN | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HHC Indiana Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Michiana Behavioral Health Center
- Psychiatric Hospital
- Plymouth, IN
- NPI 1801822440
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257120000000",
"number": "1376510610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15945 PRESWICK LN",
"city": "GRANGER",
"state": "IN",
"postal_code": "465306518",
"telephone_number": "574-273-1769",
"fax_number": "574-283-1209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 E MADISON ST",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466172322",
"telephone_number": "574-234-0061",
"fax_number": "574-283-1209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZWERNEMAN",
"first_name": "JOHN",
"middle_name": "F",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-07",
"last_updated": "2009-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IN",
"license": "01043307",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200062340A",
"state": "IN"
}
],
"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 Nov 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.