1. Home
  2. Directory
  3. Indiana
  4. Mishawaka
  5. Physical Medicine Rehabilitation
  6. NPI Profile

MICHIANA SPINE, SPORTS & OCCUPATIONAL REHAB, PC
NPI 1912074659
Physical Medicine & Rehabilitation - Pain Medicine in Mishawaka, IN

Active since November 29, 2006
3740 EDISON LAKES PKWY, MISHAWAKA, IN 46545(574) 252-4150(574) 252-4159 Get Directions Write a Review

NPPES record last updated: November 3, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 3, 2022, Oct 24, 2022 (2 updates tracked since 2022).

About Michiana Spine, Sports & Occupational Rehab, Pc NPPES

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

MICHIANA SPINE, SPORTS & OCCUPATIONAL REHAB, PC (NPI 1912074659) is a healthcare organization registered as a pain medicine in Mishawaka, Indiana and active in the NPI registry since November 2006. The organization lists Kevin Gene Drew, President, as its authorized official.

NPPES Registry Identity

NPI1912074659
Entity TypeOrganization
Primary Taxonomy2081P2900X
Legal Business NameMICHIANA SPINE, SPORTS & OCCUPATIONAL REHAB, PC
Location Address3740 EDISON LAKES PKWYMishawaka, IN 46545-3474
Mailing Address3740 Edison Lakes PkwyMishawaka, IN 46545-3474 · (574) 252-4150 · Fax (574) 252-4159
Phone(574) 252-4150
Fax(574) 252-4159
Organization SubpartNo
Authorized OfficialKevin Gene DrewPresident · (574) 252-4150
Enumeration DateNovember 29, 2006
Last NPPES UpdateNovember 3, 20222 updates tracked since enumeration
NPPES CertifiedNovember 3, 2022
✔ NPI 1912074659 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2081P2900X
License✔ Licensed in IN · 01042863
Definition
A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.
3740 EDISON LAKES PKWY, Mishawaka, IN 46545
Open in Google Maps ↗

Other Identifiers 4

OtherCI5205Railroad Medicare
Other129646400Dept Of Laboracs
Medicaid200216220AIN
Other25-0A110370MI · Bcbsmi

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, CareSource.Insurance ›

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.

JONATHAN D.V. SANNER DPT
Physical Therapist
3740 EDISON LAKES PKWY
MISHAWAKA, IN 46545
St. Joseph County (574) 252-4150
LORAINE A FISHER FNP-C
Nurse Practitioner (Family)
3740 EDISON LAKES PKWY
MISHAWAKA, IN 46545
St. Joseph County (574) 252-4150
DR. KEVIN GENE DREW MD
Physical Medicine & Rehabilitation (Pain Medicine)
3740 EDISON LAKES PKWY
MISHAWAKA, IN 46545
St. Joseph County (574) 252-4150
JOHN L KITTREDGE PA
Physician Assistant
3740 EDISON LAKES PKWY
MISHAWAKA, IN 46545
St. Joseph County (574) 252-4150

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 Michiana Spine, Sports & Occupational Rehab, PC's NPI number?

The NPI number for Michiana Spine, Sports & Occupational Rehab, PC is 1912074659. It was assigned to this organization in the NPPES registry on November 29, 2006.

Where is Michiana Spine, Sports & Occupational Rehab, PC located?

Michiana Spine, Sports & Occupational Rehab, PC is located at 3740 Edison Lakes Pkwy, Mishawaka, IN 46545. The listed phone number is (574) 252-4150.

What is Michiana Spine, Sports & Occupational Rehab, PC's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pain Medicine, with taxonomy code 2081P2900X.

What insurance does Michiana Spine, Sports & Occupational Rehab, PC accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and CareSource list Michiana Spine, Sports & Occupational Rehab, PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Michiana Spine, Sports & Occupational Rehab, PC was last updated on November 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.