Madison Center, Inc.

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

License

406-1-PIP Issued in IN

Legal business name

MADISON CENTER, INC.

Practice address

403 E Madison St
South Bend, IN 46617-2322

Phone

(574) 234-0061

Fax

(574) 283-1209

NPI assigned

Jan 8, 2007

Organization subpart

Yes

Parent organization

MADISON CENTER, INC.As reported in NPPES

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

Authorized official

Name

Brenda J Clanton

Title

Contracts Manager

Phone

(574) 283-1107

Specialties & licenses 2

Addresses

Other identifiers 1

Part of

Madison Center Inc

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Madison Center, Inc.

  • Psychiatric Hospital
  • South Bend, IN
  • NPI 1073565131
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karen L Bloomer, LCSW

  • Clinical Social Worker
  • South Bend, IN
  • NPI 1417923384
  NPD (past)
• Coral Anne Brenneise, MSW

  • Clinical Social Worker
  • Benton Harbor, MI
  • NPI 1922031327
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270598400000",
    "number": "1376691154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": {
        "organization_name": "MADISON CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MADISON CENTER, INC.",
        "enumeration_date": "2007-01-08",
        "last_updated": "2010-04-07",
        "status": "A",
        "authorized_official_last_name": "CLANTON",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CONTRACTS MANAGER",
        "authorized_official_telephone_number": "574-283-1107"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IN",
            "license": "406-1-PIP",
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "IN",
            "license": "406-1-PIP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100276950",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey S Mader, D.D.S.
• Madison Center, Inc.
• Madison Center, Inc.
• Madison Center, Inc.
• Madison Center, Inc.
• Madison Center, Inc.
• Andrea Madrigal
• Kristen Michelle Madson, PHARMD
• Makaliah Maefield
• Melinda S Maefield, MSW.LSW

• Psychiatric Hospital in South Bend, IN
• Providers in South Bend, IN by specialty
• Psychiatric Hospital in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2010; 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.