1225082878 NPI number — SAINT JOSEPH REGIONAL MEDICAL CENTER, INC.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225082878 NPI number — SAINT JOSEPH REGIONAL MEDICAL CENTER, INC.

Employer Identification Number (EIN):

Provider Organization Name:

SAINT JOSEPH REGIONAL MEDICAL CENTER, INC.

Provider Last Name:

Provider First Name:

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

Provider Gender Code:

Provider Other Organization Name:

Provider Other Organization Name Type Code:

6

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1225082878

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

07/11/2025

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

5215 HOLY CROSS PKWY

Provider Second Line Business Mailing Address:

PROVIDER SERVICES-ENROLLMENT

Provider Business Mailing Address City Name:

MISHAWAKA

Provider Business Mailing Address State Name:

IN

Provider Business Mailing Address Postal Code:

46545-1469

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

2349 LAKE AVE STE 99

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

PLYMOUTH

Provider Business Practice Location Address State Name:

IN

Provider Business Practice Location Address Postal Code:

46563-7837

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

574-948-5340

Provider Business Practice Location Address Fax Number:

574-948-5494

Provider Enumeration Date:

05/19/2006

Authorized Official Last Name:

KARAM

Authorized Official First Name:

CHRISTOPHER

Authorized Official Middle Name:

JAMES

Authorized Official Title or Position:

PRESIDENT

Authorized Official Telephone Number:

574-335-5000

• Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2086S0129X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 208800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 208G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207RC0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207RI0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207RI0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207VM0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 200162760H , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 300045987 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 300046084 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 200091160B , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 200162760A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 300046029 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: CJ6650 . This is a "RR MEDICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
• Identifier: 200162760C , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 300047494 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 021236800 . This is a "FEDERAL BLACK LUNG" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
• Identifier: 200162760B , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 300038977 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 300041953 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 300045460 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 200162760G , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 300028778 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 300026356 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 300000756 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 300000759 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 300035855 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".