ELKHART CLINIC, LLC (NPI# 1164664298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164664298 |
| Entity Type | Organization |
| Organization Name | ELKHART CLINIC, LLC |
| Practice Address |
303 S Nappanee St Elkhart IN 46514-2066 |
| Practice Telephone | 5742963200 |
| Practice Fax Number | 5742963921 |
| Mailing Telephone | 5742963200 |
| Mailing Fax Number | 5742963921 |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2009-04-06 |
| Authorized Official Name | MR. DARRYL R BUSBY (EXECUTIVE ADMINISTRATOR) |
| Authorized Official Telephone | 5742963200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902416076 | Elkhart Clinic, LLC | Surgery | 2240 Karisa Dr Ste 1, Goshen, IN 46526-6943 | 2020-08-04 |
| 1235303165 | Elkhart Clinic, LLC | Clinic/Center | 410 Park Pl, Suite B, Mishawaka, IN 46545-3557 | 2008-04-22 |
| 1215567003 | Elkhart Clinic, LLC | Clinic/Center | 2117 W Lexington Ave, Elkhart, IN 46514-1423 | 2020-01-21 |
| 1700364916 | Elkhart Clinic, LLC | Podiatrist | 1723 E Bristol St, Elkhart, IN 46514-3968 | 2018-07-31 |
| 1306381041 | Elkhart Clinic, LLC | Clinic/Center | 1020 High Rd, Bremen, IN 46506-1093 | 2017-01-05 |
| 1083165708 | Elkhart Clinic, LLC | Clinic/Center | 2222 W Lexington Ave, Suite B, Elkhart, IN 46514-1420 | 2016-10-18 |
| 1730638990 | Elkhart Clinic, LLC | Clinic/Center | 25651 County Road 20, Elkhart, IN 46517-2310 | 2016-09-29 |
| 1013380526 | Elkhart Clinic, LLC | Ophthalmology | 2222 W Lexington Ave, Elkhart, IN 46514-1420 | 2015-11-05 |
| 1518338235 | Elkhart Clinic, LLC | Clinic/Center | 1755 Fulton St, Suite A, Elkhart, IN 46514-1927 | 2015-10-08 |
| 1164846945 | Elkhart Clinic, LLC | Clinic/Center | 1122 Professional Dr, Goshen, IN 46526-3819 | 2014-02-13 |
| Street Address |
303 S NAPPANEE ST |
| City | ELKHART |
| State | IN |
| Zip Code | 46514-2066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578566675 | Pavan Ahuja | Internal Medicine | 303 S Nappanee St, Elkhart, IN 46514-2066 | 2005-05-23 |
| 1114482676 | Marla M Troyer | Nurse Practitioner | 303 S Nappanee St, Elkhart, IN 46514-2098 | 2019-02-08 |
| 1144681941 | Jennifer Ann Hartl | Nurse Practitioner | 303 S Nappanee St, Elkhart, IN 46514-2066 | 2016-03-08 |
| 1194078634 | Abigail Anne Johnson | Audiologist | 303 S Nappanee St, Elkhart, IN 46514-2066 | 2012-10-22 |
| 1932402997 | Elkhart General Hospital, Inc. | General Acute Care Hospital | 303 S Nappanee St, Suite B, Elkhart, IN 46514-2066 | 2010-12-14 |
| 1700187457 | Beacon Medical Group, Inc. | Internal Medicine | 303 S Nappanee St, Suite A, Elkhart, IN 46514-2066 | 2010-11-11 |
| 1043537020 | Emily A Mitchell | Surgery | 303 S Nappanee St, Elkhart, IN 46514-2066 | 2010-04-29 |
| 1851531149 | Juanito U Uy Jr. | Internal Medicine | 303 S Nappanee St, Elkhart, IN 46514-2066 | 2009-02-25 |
| 1063678878 | George Collins Nwadiaro | Internal Medicine | 303 S Nappanee St, Elkhart, IN 46514-2066 | 2008-07-31 |
| 1710155718 | Eqdam N Radhi | Internal Medicine | 303 S Nappanee St, Elkhart, IN 46514-2066 | 2008-02-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891333522 | Adam Collier | Nurse Anesthetist, Certified Registered | 600 Elkhart Boulvard, Elkhart, IN 46514 | 2019-12-12 |
| 1861034688 | Heart City Health Center, Inc. | Obstetrics & Gynecology | 1545 Cassopolis Street, Elkhart, IN 46514 | 2019-10-14 |
| 1982263398 | Fresenius Medical Care North Elkhart, LLC | Clinic/Center | 801 W Bristol St, Elkhart, IN 46514 | 2019-06-10 |
| 1487118220 | Hellenic Senior Living of Elkhart, LLC | Assisted Living Facility | 2528 Bypass Road, Elkhart, IN 46514 | 2019-01-25 |
| 1922595792 | Anna Cornelia Smith | Nutritionist | 51803 Tall Pines Dr, Elkhart, IN 46514 | 2018-04-17 |
| 1114438496 | Erika Lynn Farrell | Counselor | 3120 Suite B Windsor Court, Elkhart, IN 46514 | 2017-10-13 |
| 1740728948 | Michael Scheretie | Nurse Anesthetist, Certified Registered | 52866 Wildflower Ln, Elkhart, IN 46514 | 2017-02-08 |
| 1821355876 | Marcy Lynn Adams | Nurse Practitioner | 1104 W Bristol St, Elkhart, IN 46514 | 2012-04-16 |
| 1053694265 | Paul A. Price | Pharmacist | 1400 Cassopolis St., Elkhart, IN 46514 | 2011-09-23 |
| 1528362647 | Beacon Medical Group, Inc. | Internal Medicine | 500 Arcade Ave., Suite 400, Elkhart, IN 46514 | 2011-01-04 |
| Find all providers in zip 46514 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164401469 | Jerald A Hochstetler | Urology | 105 N Nappanee St, Elkhart, IN 46514-1957 | 2006-01-13 |
| 1114564762 | Sunny Marie Johnson | Urology | 105 N Nappanee St, Elkhart, IN 46514-1957 | 2019-12-03 |
| 1457331340 | Michael H Thomas | Urology | 105 N Nappanee St, Elkhart, IN 46514-1957 | 2006-01-18 |
| 1417936725 | Anish H Nayee | Urology | 105 N Nappanee St, Elkhart, IN 46514-1957 | 2006-01-13 |
| 1538148838 | Peter C Fretz | Urology | 105 N Nappanee St, Elkhart, IN 46514-1957 | 2006-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336752799 | Mark Alexander Assmus | Urology | 1801 Senate Blvd Ste 220, Indianapolis, IN 46202-1260 | 2020-08-26 |
| 1124653803 | Catherine Baugher | Urology | 2525 W University Ave Ste 504, Muncie, IN 47303-3409 | 2020-03-03 |
| 1245881812 | Carol Jean Stephens | Urology | 1000 N 16th St Ste 210, New Castle, IN 47362-4319 | 2019-09-25 |
| 1376960302 | Mohammad Mahmoud | Urology | 535 Barnhill Dr Ste 150, Indianapolis, IN 46202-5116 | 2014-03-27 |
| 1114364064 | Alexander J Tatem | Urology | 8240 Naab Rd Ste 220, Indianapolis, IN 46260-1950 | 2013-06-03 |
| 1699015941 | Frank Walerko | Urology | 809 Bittersweet Cove Drive, Mishawaka, IN 46544 | 2013-02-25 |
| 1861744997 | Vincent Joseph Santare | Urology | 134 Carnoustie Ln, Schererville, IN 46375-2926 | 2012-10-13 |
| 1821353814 | Little Company of Mary Hospital of Indiana Inc | Urology | 600 W 13th Street, Suite 105, Jasper, IN 47546-1882 | 2012-07-06 |
| 1154681369 | Joshua David Roth | Urology | 705 Riley Hospital Dr Ste 4230, Indianapolis, IN 46202-5109 | 2012-05-22 |
| 1801152210 | Richard James Holloway | Urology | 18799 Arapaho Ln, South Bend, IN 46637 | 2012-04-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.