Individual provider Active NPI

Cynthia E Mayfield, MD

  • Dermatology Physician
  • South Bend, IN
National Provider Identifier
1649260233
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
01039573A Issued in IN
Practice address
2102 E Inwood Rd
South Bend, IN 46614-2443
Phone
(574) 299-2400
Fax
(574) 299-2410
NPI assigned
Oct 25, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 01039573A IN Primary

Addresses

Primary practice location

2102 E Inwood Rd
South Bend, IN 46614-2443

Mailing address

2102 E Inwood Rd
South Bend, IN 46614-2443
Phone (574) 299-2400

Other identifiers 1

IdentifierTypeStateIssuer
100092010MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1649260233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 E INWOOD RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142443",
            "telephone_number": "574-299-2400",
            "fax_number": "574-299-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 E INWOOD RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142443",
            "telephone_number": "574-299-2400",
            "fax_number": "574-299-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYFIELD",
        "first_name": "CYNTHIA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01039573A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100092010",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.