Jeffrey S McBride, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12008926 Issued in IN

Practice address

117 S Nappanee St
Elkhart, IN 46514-1955

Phone

(574) 293-8211

Fax

(574) 295-8270

NPI assigned

Oct 11, 2006

Sex

Male

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

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1992893309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 S NAPPANEE ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141955",
            "telephone_number": "574-293-8211",
            "fax_number": "574-295-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S NAPPANEE ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141955",
            "telephone_number": "574-293-8211",
            "fax_number": "574-295-8270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12008926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER #",
            "identifier": "000000083627",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Elliott Maxwell, DDS
• Meredith Alcinda Mayfield, PA-C
• Tyra C Mays, MSW
• McArthur Counseling Services PLLC
• Joel Thomas McArthur, MA, LMHC
• Lorraine McBride
• Rosalie L McBride, M.D.
• Gabrielle McCaskill
• Stacy Lynn McCaughn, LMHC
• Katherine Ellen McCulley, BA

• Oral and Maxillofacial Surgery (Dentist) in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.