1. Home
  2. Directory
  3. Indiana
  4. South Bend
  5. Family Medicine
  6. NPI Profile

EVANS KIRKWOOD LODGE MD, PHD
NPI 1710737366
Family Medicine in South Bend, IN

Active since March 26, 2024PECOS Enrolled
714 N MICHIGAN ST, SOUTH BEND, IN 46601(574) 647-7477 Get Directions Write a Review

NPPES record last updated: December 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 8, 2025, Aug 25, 2024 (2 updates tracked since 2024).

About Evans Kirkwood Lodge Md, Phd NPPES

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

EVANS KIRKWOOD LODGE MD, PHD (NPI 1710737366) is an individual family medicine provider in South Bend, Indiana, licensed in Indiana (01097297A) and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710737366
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameEVANS KIRKWOOD LODGECredential: MD, PHD
Location Address714 N MICHIGAN STSouth Bend, IN 46601-1035
Mailing Address714 N Michigan StSouth Bend, IN 46601-1035 · (574) 647-7477 · Fax (574) 647-6819
Phone(574) 647-7477
Sole ProprietorNo
Enumeration DateMarch 26, 2024
Last NPPES UpdateDecember 8, 20252 updates tracked since enumeration
NPPES CertifiedDecember 8, 2025
✔ NPI 1710737366 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IN · 01097297A
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.
714 N MICHIGAN ST, South Bend, IN 46601
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Evans Kirkwood Lodge Md, Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

DR. DAVID HENRY TALARICO MD
Student in an Organized Health Care Education/Training Program
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
ABIGAIL LEIGH REESE DO
Student in an Organized Health Care Education/Training Program
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
DALE ALAN PATTERSON M.D.
Family Medicine
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
MATTHEW T. DUPRE MD
Family Medicine
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
RICHARD J. WARD MD
Family Medicine
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
VICTORIA ANN BAWEL MD
Student in an Organized Health Care Education/Training Program
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
ISAAC D HATTON MD
Family Medicine
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7913
LAURA LAWRENCE DO
Student in an Organized Health Care Education/Training Program
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477

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 Evans Lodge's NPI number?

The NPI number for Evans Lodge is 1710737366. It was assigned to this individual provider in the NPPES registry on March 26, 2024.

Where is Evans Lodge located?

Evans Lodge practices at 714 N Michigan St, South Bend, IN 46601. The listed phone number is (574) 647-7477.

What is Evans Lodge's specialty?

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

Is Evans Lodge enrolled in Medicare?

Yes. Evans Lodge is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Evans Lodge was last updated on December 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.