Individual provider Active NPI

John F Powell, M.D.

  • Family Medicine Physician
  • South Bend, IN
National Provider Identifier
1689618068
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01029534A Issued in IN
Practice address
234 Chapin St Ste I
South Bend, IN 46601-2571
Phone
(574) 335-8250
Fax
(574) 335-0788
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01029534A IN Primary

Addresses

Primary practice location

234 Chapin St Ste I
South Bend, IN 46601-2571

Mailing address

707 Cedar St Ste 405
South Bend, IN 46617-2059

Other identifiers 2

IdentifierTypeStateIssuer
1102413754OtherINANTHEM
100223260MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110308000113 IN Practitioner - Family Practice 8527240886 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc. Family Medicine CurrentSince Sep 10, 2019 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc. CurrentSince Sep 10, 2019 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Current Accepting new patients
Saint Joseph Regional Medical Center, Inc. Current Accepting new patients

Locations

60101 Bodnar Blvd
Ste 100B
Mishawaka, IN 46544
Phone (574) 335-8500

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

611 E Douglas Rd
Ste 309
Mishawaka, IN 46545
Phone (574) 335-6232

611 E Douglas Rd
Ste 137
Mishawaka, IN 46545
Phone (574) 335-6214

234 Chapin St
Ste I
South Bend, IN 46601
Phone (574) 274-4552

707 Cedar St
Ste 200
South Bend, IN 46617
Phone (574) 237-1328

1122 S Ironwood Dr
South Bend, IN 46615
Phone (574) 335-8399

Interoperability endpoints

  • Direct secure messaging: jpowell1154419@direct.trinity-health.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1689618068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 CEDAR ST STE 405",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 CHAPIN ST STE I",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466012571",
            "telephone_number": "574-335-8250",
            "fax_number": "574-335-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "JOHN",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01029534A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1102413754",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100223260",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.