Mishawaka Clinic, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MISHAWAKA CLINIC, P.C.

Practice address

303 S. Main St.
Suite 212
Mishawaka, IN 46544

Phone

(574) 254-0800

Fax

(574) 254-0812

NPI assigned

Apr 10, 2008

Organization subpart

No

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

Authorized official

Name

Dr. James E. Reidy, M.D.

Title

President

Phone

(574) 254-0800

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302220800000",
    "number": "1972776938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 S. MAIN ST.",
            "address_2": "SUITE 212",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "46544",
            "telephone_number": "574-254-0800",
            "fax_number": "574-254-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S. MAIN ST.",
            "address_2": "SUITE 212",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "46544",
            "telephone_number": "574-254-0800",
            "fax_number": "574-254-0812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISHAWAKA CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2011-04-08",
        "status": "A",
        "authorized_official_last_name": "REIDY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-254-0800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497794010",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Garrett Milosevich
• Perry Minner Jr., LCSW
• Miracle Homecare LLC
• Miracle Lane Family Dentistry P.C.
• Pedro A Miro, MD
• Mishawaka Dental LLC
• Mishawaka Family Pharmacy LLC
• Mishawaka Il/Al, LLC
• Mishawaka Medical Arts Pharmacy
• Mishawaka Orthopedics and Sports Medicine P C

• Family Medicine Physician in Mishawaka, IN
• Providers in Mishawaka, 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 Apr 8, 2011; 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.