Mishawaka Orthopedics and Sports Medicine P C

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

50003916A Issued in IN

Legal business name

MISHAWAKA ORTHOPEDICS AND SPORTS MEDICINE P C

Practice address

270 E Day Rd
Ste 200
Mishawaka, IN 46545-3444

Phone

(574) 271-5151

Fax

(574) 271-5175

NPI assigned

Sep 15, 2005

Last updated

Mar 17, 2015By 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

Dr. Charles McDonald Ware Jr., M.D.NPI 1881689834

Title

President

Phone

(574) 271-5151

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.70617

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.

• Charles McDonald Ware Jr., M.D.

  • Orthopaedic Surgery Physician
  • Mishawaka, IN
  • NPI 1881689834
  Medicare reassignment Care Compare group NPD Authorized official
• Mason P Haye, PA-C, ATC

  • Physician Assistant
  • Mishawaka, IN
  • NPI 1871100503
  Medicare reassignment Care Compare group
• Thomas Gerard Akre, DO

  • Orthopaedic Surgery Physician
  • South Bend, IN
  • NPI 1235132903
  NPD (past)
• Robert B Barber, MD

  • Adult Medicine Physician
  • Indianapolis, IN
  • NPI 1508886474
  NPD (past)
• Lynnford S Wilson, M.D.

  • Orthopaedic Surgery Physician
  • Sterling, VA
  • NPI 1588645865
  NPD (past)

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1578558458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 E DAY RD",
            "address_2": "STE 200",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453444",
            "telephone_number": "574-271-5151",
            "fax_number": "574-271-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 E DAY RD",
            "address_2": "STE 200",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453444",
            "telephone_number": "574-271-5151",
            "fax_number": "574-271-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISHAWAKA ORTHOPEDICS AND SPORTS MEDICINE P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-15",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "WARE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "MCDONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-271-5151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IN",
            "license": "50003916A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200248370A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CE8821",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000000104753",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mishawaka Clinic, P.C.
• Mishawaka Dental LLC
• Mishawaka Family Pharmacy LLC (Mishawaka Family Pharmacy)
• Mishawaka Il/Al, LLC
• Mishawaka Medical Arts Pharmacy
• Mishawaka Osteopathic Clinic
• Mishawaka Osteopathic Clinic
• Mishawaka RCF LP (Silver Birch of Mishawaka)
• Mishawaka Rehab LLC
• Mishawaka Sleep Inc (Koala Center for Sleep & TMJ Disorders - IN3)

• Sports Medicine (Orthopaedic Surgery) Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.