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

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