Family Medicine Center of Plymouth PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

02001552 Issued in IN

Legal business name

FAMILY MEDICINE CENTER OF PLYMOUTH PC

Practice address

1904 Lake Ave
Plymouth, IN 46563-7828

Phone

(574) 936-3178

Fax

(574) 936-1084

NPI assigned

Jan 24, 2007

Last updated

Jan 16, 2008By 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

Dr. Harold A Barnard, D.O.NPI 1710074612

Title

President

Phone

(574) 936-3178

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 4

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.

• Harold Alan Barnard, D O

  • Family Medicine Physician
  • Greenville, TX
  • NPI 1710074612
  NPD (past) Authorized official
• Randell J Coulter, D.O.

  • Family Medicine Physician
  • Rochester, IN
  • NPI 1689659732
  NPD (past)
• Patrick E Southe, MD

  • Emergency Medicine Physician
  • Granger, IN
  • NPI 1396764270
  NPD (past)
• Dawn Marie Gavagan Simala Young, D.O.

  • Family Medicine Physician
  • Leland, NC
  • NPI 1750368726
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1942355466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 LAKE AVE",
            "address_2": "P O BOX 969",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465637828",
            "telephone_number": "574-936-3178",
            "fax_number": "574-936-1084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 LAKE AVE",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465637828",
            "telephone_number": "574-936-3178",
            "fax_number": "574-936-1084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE CENTER OF PLYMOUTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "BARNARD",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-936-3178",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IN",
            "license": "02001552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000093835",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20029880",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glenda Ensweiler, NP
• Eric Foster, Inc.
• Monica Esquivel, R.D.
• Jacqueline Ann Eveland, N.P.
• Family Dental Care, Chad Shaw D.D.S.,P.C.
• Donald Joseph Faulkner, M.D.
• Mariel Regina Feeks, PHARMD
• Travis Paul Fernandez, RPH
• FH Decks and Landscaping Inc
• Amy Marie Fish, NP

• Clinic/Center in Plymouth, IN
• Providers in Plymouth, IN by specialty
• Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; 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.