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

Mitchell Daugherty

Individual provider Family Medicine Physician · NPI 1417481540

Mitchell Daugherty is a Family Practice in South Bend, Indiana. Graduated from University of Illinois College of Med (CHI/PEOR/ROCK/Chm-Urb) in 2017, 9 years ago. Practices with Beacon Medical Group Inc, a 574-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
9
Trained at
University of Illinois College of Med (CHI/PEOR/ROCK/Chm-Urb)
Licensed in
IN
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

1815 E Ireland Rd
South Bend, IN 46614-2845
Phone: (574) 647-1700
Fax: (574) 647-7572
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 900 I St, La Porte, IN 46350-5533 — (219) 324-1700
  • 714 N Michigan St, South Bend, IN 46601-1035 — (574) 647-7477
  • 111 W Jefferson Blvd Ste 100, South Bend, IN 46601-1993 — (574) 647-1670
  • 100 Navarre Pl Ste 4440, South Bend, IN 46601-1171 — (574) 647-5300

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X · Licence 01082368A (IN)
Family Medicine Physician Taxonomy 207Q00000X · Licence 01082368A (IN)

Record details

NPI number1417481540
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 14, 2017
Last updated in NPPESJune 20, 2025
Certification dateJune 20, 2025
Mailing address710 N Niles Ave, South Bend, IN 46617-1924

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Also practisesSPORTS MEDICINE
Medical schoolUNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated 2017 (9 years in practice)
Group practice Beacon Medical Group Inc — 574 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in South Bend