Michiana Primary Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MICHIANA PRIMARY CARE LLC

Practice address

615 Fulmer Rd
Mishawaka, IN 46544

Phone

(574) 252-3085

Fax

(574) 252-5906

NPI assigned

Jun 24, 2010

Organization subpart

No

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

Authorized official

Name

James Flynn

Title

Ceo

Phone

(574) 231-6800

Specialties & licenses 1

Addresses

Other names 1

• Unity Family Medicine Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• United Surgeons, LLC

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1518197011

  Member Of

  NPD member

Locations

Practitioners 2

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

• Joe Edward Banks, D.O.

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1154508075
  NPD (past)
• Jena M Corban, MSN

  • Family Nurse Practitioner
  • Mishawaka, IN
  • NPI 1134129919
  NPD (past)

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1639480643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 EDISON LAKES PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451442",
            "telephone_number": "574-231-6800",
            "fax_number": "574-231-6845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 FULMER RD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "46544",
            "telephone_number": "574-252-3085",
            "fax_number": "574-252-5906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 Park Pl Ste B",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465453557",
            "country_code": "US",
            "telephone_number": "574-564-5863",
            "fax_number": "716-242-3028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MICHIANA PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-24",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "574-231-6800"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Unity Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michiana Hematology-Oncology P C
• Michiana Hematology-Oncology P C
• Michiana Interventional and Vascular Services, LLC
• Michiana Mental Health Care, LLC.
• Michiana Neuroscience, LLC
• Michiana Speech Therapy LLC
• Michiana Spine, Sports & Occupational Rehab, PC
• Michiana Surgery Center, LLC
• Michiana Wellness and Longevity Clinic, Inc.
• Rachel Lynn Mickelson, PSYD

• Family Medicine Physician in Mishawaka, IN
• Providers in Mishawaka, 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 17, 2019; 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.