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PHYSICIAN MANAGEMENT SERVICES OF INDIANA II, LLC
NPI 1053993014
Family Medicine in South Bend, IN

Active since April 28, 2021
300 S SAINT LOUIS BLVD STE 204, SOUTH BEND, IN 46617(888) 829-8550 Get Directions Write a Review

NPPES record last updated: April 28, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Physician Management Services Of Indiana Ii, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHYSICIAN MANAGEMENT SERVICES OF INDIANA II, LLC (NPI 1053993014) is a healthcare organization registered as a family medicine in South Bend, Indiana and active in the NPI registry since April 2021. The organization lists Brett Kenefick, President, as its authorized official.

NPPES Registry Identity

NPI1053993014
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePHYSICIAN MANAGEMENT SERVICES OF INDIANA II, LLC
Location Address300 S SAINT LOUIS BLVD STE 204South Bend, IN 46617-3044
Mailing Address3113 Lawton Rd Ste 250Orlando, FL 32803-3517
Phone(888) 829-8550
Organization SubpartYesParent: Vaxcare Corporation
Authorized OfficialBrett KenefickPresident · (888) 829-8550
Enumeration DateApril 28, 2021
NPPES CertifiedApril 28, 2021
✔ NPI 1053993014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
300 S SAINT LOUIS BLVD STE 204, South Bend, IN 46617
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BAILEY SWAN MD
Family Medicine
300 S SAINT LOUIS BLVD STE 204
SOUTH BEND, IN 46617
St. Joseph County (574) 251-1200
PRIMARY CARE PARTNERS OF SOUTH BEND
Family Medicine
300 S SAINT LOUIS BLVD STE 204
SOUTH BEND, IN 46617
St. Joseph County (574) 251-1200
GWENDOLYN DEHORN LCSW LLC
Social Worker (Clinical)
300 S SAINT LOUIS BLVD STE 204
SOUTH BEND, IN 46617
St. Joseph County (574) 245-3920
ROBIN MARIE YAZEL MSED
Counselor (Mental Health)
300 S SAINT LOUIS BLVD STE 204
SOUTH BEND, IN 46617
St. Joseph County (574) 251-1200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Physician Management Services Of Indiana II, LLC's NPI number?

The NPI number for Physician Management Services Of Indiana II, LLC is 1053993014. It was assigned to this organization in the NPPES registry on April 28, 2021.

Where is Physician Management Services Of Indiana II, LLC located?

Physician Management Services Of Indiana II, LLC is located at 300 S Saint Louis Blvd Ste 204, South Bend, IN 46617. The listed phone number is (888) 829-8550.

What is Physician Management Services Of Indiana II, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Physician Management Services Of Indiana II, LLC was last updated on April 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.