Star Psychiatric Services PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

STAR PSYCHIATRIC SERVICES PC

Practice address

239 N Dixie Way
South Bend, IN 46637-3309

Phone

(574) 243-0112

NPI assigned

Oct 5, 2012

Last updated

Oct 26, 2012By 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

Mr. Khutb Uddin, M.D.PHD.NPI 1336234756

Title

Owner

Phone

(574) 243-0112

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 1

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.

• Khutb Mohammed Uddin, MD

  • Psychiatry Physician
  • South Bend, IN
  • NPI 1336234756
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351209600000",
    "number": "1700138492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 N DIXIE WAY",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466373309",
            "telephone_number": "574-243-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 N DIXIE WAY",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466373309",
            "telephone_number": "574-243-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR PSYCHIATRIC SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-05",
        "last_updated": "2012-10-26",
        "status": "A",
        "authorized_official_last_name": "UDDIN",
        "authorized_official_first_name": "KHUTB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-243-0112",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D.PHD."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Stair, RBT
• Peri R Stangas, PA-C
• Ronald Stangebye, DDS
• Cynthia Danielle Stanton
• Catherine Stapleford, MSED
• Star Psychiatric Services PC
• Michael J Star
• Starlight Care Facilities, Inc (Morningcrest Nursing and Memory Care Center)
• Starline Community Services Inc
• Anthony Starzynski

• Psychiatry Physician in South Bend, IN
• Providers in South Bend, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; 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.