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JACK MCINTYRE KIMMELL
NPI 1740731116
Student in an Organized Health Care Education/Training Program in South Bend, IN

Active since October 20, 2016
1526 EAST LASALLE, SOUTH BEND, IN 46617(574) 310-1911 Get Directions Write a Review

NPPES record last updated: October 20, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jack Mcintyre Kimmell NPPES

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

JACK MCINTYRE KIMMELL (NPI 1740731116) is an individual student in an organized health care education/training program in South Bend, Indiana, licensed in Indiana (3925375607) and active in the NPI registry since October 2016.

NPPES Registry Identity

NPI1740731116
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACK MCINTYRE KIMMELL
Location Address1526 EAST LASALLESouth Bend, IN 46617
Mailing Address1526 E Lasalle AveSouth Bend, IN 46617-2606 · (574) 310-1911
Phone(574) 310-1911
Sole ProprietorNo
Enumeration DateOctober 20, 2016
✔ NPI 1740731116 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in IN · 3925375607
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedSpecialist/Technologist · Athletic TrainerTaxonomy 2255A2300X · License 3925375607 (IN)
1526 EAST LASALLE, South Bend, IN 46617
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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 Jack Kimmell's NPI number?

The NPI number for Jack Kimmell is 1740731116. It was assigned to this individual provider in the NPPES registry on October 20, 2016.

Where is Jack Kimmell located?

Jack Kimmell practices at 1526 East Lasalle, South Bend, IN 46617. The listed phone number is (574) 310-1911.

What is Jack Kimmell's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Jack Kimmell was last updated on October 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.