Individual provider Active NPI

Christina Marie Cavinder, CPNP-PC

  • Pediatric Nurse Practitioner
  • South Bend, IN
National Provider Identifier
1669733887
Registry record updated Jun 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
28113458A Issued in IN
Practice address
615 N Michigan St
South Bend, IN 46601-1033
Phone
(574) 647-7141
NPI assigned
Jun 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 28113458A IN Primary

Addresses

Primary practice location

615 N Michigan St
South Bend, IN 46601-1033

Mailing address

4848 N Range Rd
La Porte, IN 46350-7613
Phone (219) 324-0132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
28113458AINMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1669733887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4848 N RANGE RD",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463507613",
            "telephone_number": "219-324-0132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011033",
            "telephone_number": "574-647-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVINDER",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "28113458A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; 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.