Active NPI
Jody Joseph, FNP
- Family Nurse Practitioner
- Plymouth, IN
National Provider Identifier
1861663510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71002470A
- Practice address
- 2349 Lake Ave Ste 100
Plymouth, IN 46563-7836 - Phone
- (574) 472-6700
- Fax
- (574) 941-3112
- NPI assigned
- Mar 20, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71002470A | IN | Primary |
Addresses
Primary practice location
2349 Lake Ave Ste 100
Plymouth, IN 46563-7836
Mailing address
PO Box 6309
South Bend, IN 46660-6309
Phone (574) 472-6700
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000726441 | Other | BCBS | |
| 200893890 | Medicaid | IN | |
| 000000726441 | Other | IN | BCBS |
| 000000562397 | Other | IN | ANTHEM, BCBS |
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Joseph Regional Medical Center, Inc. | Past | Accepting new patients | |
| Saint Joseph Regional Medical Center, Inc. | Family | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pulmonary Disease Physician
- Plymouth, IN
- NPI 1225082878
-
- Family Medicine Physician
- Mishawaka, IN
- NPI 1467406074
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377561600000",
"number": "1861663510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6309",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466606309",
"telephone_number": "574-472-6700",
"fax_number": "574-335-0760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2349 LAKE AVE STE 100",
"city": "PLYMOUTH",
"state": "IN",
"postal_code": "465637836",
"telephone_number": "574-472-6700",
"fax_number": "574-941-3112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSEPH",
"first_name": "JODY",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-20",
"last_updated": "2013-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71002470A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "000000726441",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200893890",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "000000726441",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM, BCBS",
"identifier": "000000562397",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.