Primary Care Partners of South Bend

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PRIMARY CARE PARTNERS OF SOUTH BEND

Practice address

300 S Saint Louis Blvd Ste 204
South Bend, IN 46617-3044

Phone

(574) 251-1200

Fax

(574) 251-1230

NPI assigned

Oct 28, 2019

Last updated

Jul 10, 2020By 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

Brandon Zabukovic, MDNPI 1710962915

Title

Managing Member

Phone

(574) 274-9425

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20750/brand/1/csg/1/fhir/r4

Practitioners 5

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.

• Brandon William Zabukovic, M.D.

  • Family Medicine Physician
  • South Bend, IN
  • NPI 1710962915
  Medicare reassignment Care Compare group NPD Authorized official
• Christine Elizabeth Coulter, MSN, FNP

  • Family Nurse Practitioner
  • South Bend, IN
  • NPI 1144479460
  Medicare reassignment Care Compare group NPD
• Rebekah Kottkamp, FNP-BC

  • Family Nurse Practitioner
  • South Bend, IN
  • NPI 1881018729
  Medicare reassignment Care Compare group NPD
• Bailey Swan, MD

  • Family Medicine Physician
  • South Bend, IN
  • NPI 1326627258
  Medicare reassignment Care Compare group NPD
• Mary Hope Griffin, M.D.

  • Pediatrics Physician
  • South Bend, IN
  • NPI 1659402220
  Medicare reassignment NPD

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594339200000",
    "number": "1497399927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S SAINT LOUIS BLVD STE 204",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173044",
            "telephone_number": "574-251-1200",
            "fax_number": "574-251-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S SAINT LOUIS BLVD STE 204",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173044",
            "telephone_number": "574-251-1200",
            "fax_number": "574-251-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE PARTNERS OF SOUTH BEND",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-28",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A",
        "authorized_official_last_name": "ZABUKOVIC",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "574-274-9425",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Auna L. Skarning Preston, PH.D.
• Ashlee Price
• Jamie Rexine Price, M.A., L.M.H.C.
• Olivia Papai Price, PA-C
• Russell Lee Price Jr., LCSW
• Prime Life Care LLC
• Brianna Primrose, NP
• Jennifer Clare Prins, M.D.
• Sarah Ellen Pritt, MS
• Proactive Health, Inc

• Family Medicine Physician in South Bend, IN
• Providers in South Bend, 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 Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.