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Organization

SAINT JOSEPH REGIONAL MEDICAL CENTER, INC.

Active
Parent organization
TRINITY HEALTH ACADEMIC INTERNAL MEDICINE-NORTHWEST LIVONIA
Other names
Saint Joseph Medical Group
Organization subpart
Yes

Provider details

NPI number
Legal business name
TRINITY HEALTH ACADEMIC INTERNAL MEDICINE-NORTHWEST LIVONIA
Authorized official
CHRISTOPHER JAMES KARAM (PRESIDENT)
(574) 335-5000
Entity
Organization

Contact information

Practice address
60101 BODNAR BLVD STE 100B, MISHAWAKA, IN 46544-9340
(574) 335-8500
(574) 335-0794
Mailing address
5215 HOLY CROSS PKWY, PROVIDER SERVICES-ENROLLMENT, MISHAWAKA, IN 46545-1469
(574) 335-8707

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
207V00000X
Obstetrics & Gynecology Physician
208000000X
Pediatrics Physician
261QU0200X
Urgent Care Clinic/Center
363L00000X
Nurse Practitioner
363LF0000X
Family Nurse Practitioner
363LP0200X
Pediatric Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
021236800
FEDERAL BLACK LUNG
IN
05
100173780A
IN
05
100382620A
IN
05
100461640B
IN
05
100461640D
IN
05
100461640E
IN
05
100461640F
IN
05
100461640G
IN
05
100461640H
IN
05
200041520D
IN
05
200045130A
IN
05
300000754
IN
05
300046748
IN
05
300086087
IN
01
CJ6650
RR MEDICARE
IN
Enumeration date
05/19/2006
Last updated
03/03/2026
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