Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack McIntyre Kimmell

Individual provider Athletic Trainer · NPI 1740731116

Jack McIntyre Kimmell is an Athletic Trainer in South Bend, Indiana. Licensed in Indiana. Registered with an NPI since 2016.

Licensed in
IN
In the registry since
2016
Specialties on file
2

Practice location Address checks out

1526 E Lasalle
South Bend, IN 46617
Phone: (574) 310-1911
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X · Licence 3925375607 (IN)
Athletic Trainer Taxonomy 2255A2300X · Licence 3925375607 (IN)

Record details

NPI number1740731116
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 20, 2016
Last updated in NPPESOctober 20, 2016
Mailing address1526 E Lasalle Ave, South Bend, IN 46617-2606

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