Mary Mahern, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01037667A Issued in IN

Practice address

642 S Walker St
Bloomington, IN 47403-2158

Phone

(812) 331-9160

Fax

(812) 336-0277

NPI assigned

Sep 15, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Indiana University Health Southern Indiana Physicians, LLC

  • Multi-Specialty Clinic/Center
  • Bloomington, IN
  • NPI 1013953983
  Medicare reassignment
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1962497933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 S WALKER ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032158",
            "telephone_number": "812-331-9160",
            "fax_number": "812-336-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 S WALKER ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032158",
            "telephone_number": "812-331-9160",
            "fax_number": "812-336-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHERN",
        "first_name": "MARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-15",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01037667A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100184710",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmahern@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "642 S Walker St",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474032158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Natasha Magers, RBT
• Keely Nicole Magill, MA-BCBA
• Megan Magrane, MD
• Madison Magyar, LCSW
• Emily Christine Mahan, MS
• Lola Isabella Mahner, LCSW
• Rachel Sarah Mahrt, SLP
• John Gabriel Maijub, MD
• Anna Main, AU.D.
• Amy C Makice, MSW, LCSW

• Family Medicine Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.