ELKHART CLINIC, LLC (NPI# 1164846945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164846945 |
Entity Type | Organization |
Organization Name | ELKHART CLINIC, LLC |
Practice Address |
1122 Professional Dr Goshen IN 46526-3819 |
Mailing Address |
Po Box 2968 Elkhart IN 46515-2968 |
Practice Telephone | 5742963291 |
Practice Fax Number | 5742963383 |
Mailing Telephone | 5742963200 |
Mailing Fax Number | 5742963392 |
Enumeration Date | 2014-02-13 |
Last Update Date | 2014-02-13 |
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 | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 100466600 | 05 |
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 |
1962788141 | Elkhart Clinic, LLC | Clinic/Center | 2120 Rieth Blvd, Suite A, Goshen, IN 46526-5843 | 2011-11-01 |
Street Address |
1122 PROFESSIONAL DR |
City | GOSHEN |
State | IN |
Zip Code | 46526-3819 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851385660 | James R Vancuren | Obstetrics & Gynecology | 1122 Professional Dr, Goshen, IN 46526-3819 | 2005-09-07 |
1942754353 | Rebecca Gindelberger | Obstetrics & Gynecology | 1122 Professional Dr, Goshen, IN 46526-3819 | 2016-08-15 |
1720491947 | Ashley Scott | Obstetrics & Gynecology | 1122 Professional Dr, Goshen, IN 46526 | 2014-06-05 |
1497053599 | Ellen Elizabeth Cuddeback | Obstetrics & Gynecology | 1122 Professional Dr, Goshen, IN 46526-3819 | 2011-03-14 |
1083857023 | James Nnuro Frimpong | Obstetrics & Gynecology | 1122 Professional Dr, Goshen, IN 46526-3819 | 2009-04-07 |
1598969693 | Margaret E Elmore | Advanced Practice Midwife | 1122 Professional Dr, Goshen, IN 46526-3819 | 2007-06-13 |
1902927965 | Alison J Mattern | Nurse Practitioner | 1122 Professional Dr, Goshen, IN 46526-3819 | 2007-04-03 |
1821041278 | Peter M Delneky | Obstetrics & Gynecology | 1122 Professional Dr, Goshen, IN 46526-3819 | 2006-05-18 |
1609860246 | Lawrence J Smith | Obstetrics & Gynecology | 1122 Professional Dr, Goshen, IN 46526-3819 | 2005-09-09 |
1558355362 | Nancy L Loewen | Advanced Practice Midwife | 1122 Professional Dr, Goshen, IN 46526-3819 | 2005-09-07 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134631344 | Heidi Kauffmann | Social Worker | 2606 Peddler's Village Rd. Suite 210, Goshen, IN 46526 | 2017-10-27 |
1952812034 | Blue Diamond Villas | Skilled Nursing Facility | 1510 Sandpiper Lane, Goshen, IN 46526 | 2017-10-17 |
1578086534 | Anthony Escotto | Physical Therapist | 223 North Chicago Avenue, Goshen, IN 46526 | 2017-07-21 |
1831544774 | April Noelle Hart | Registered Nurse | 2606 Peddlers Village Rd., Suite 215, Goshen, IN 46526 | 2016-04-28 |
1639530108 | Amanda Miller | Physical Therapy Assistant | 114 Watertower Court, Goshen, IN 46526 | 2016-03-11 |
1720486095 | Gloria White | Pharmacist | 4430 Elkhart Road, C/o Walgreens, Goshen, IN 46526 | 2014-12-18 |
1184982472 | Dianna Christine Hoover | Occupational Therapist | 1627 Autumn Blaze Lane, Goshen, IN 46526 | 2012-04-24 |
1629361357 | Amy Rebecca Pointon | Nurse Practitioner | 1615 Winsted Dr Ste 1, Goshen, IN 46526 | 2011-05-27 |
1659670685 | Michiana Eye Center LLC | Optometrist | 1747 Stafford Ct, Goshen, IN 46526 | 2011-03-16 |
1467759001 | Natasha Candace Pontius | Occupational Therapy Assistant | 2400 College Aveune, Goshen, IN 46526 | 2011-02-17 |
Find all providers in zip 46526 |
Taxonomy Code | 261QM1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Multi-Specialty |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962788141 | Elkhart Clinic, LLC | Clinic/Center | 2120 Rieth Blvd, Suite A, Goshen, IN 46526-5843 | 2011-11-01 |
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1659984870 | Central Indiana Vascular Care, LLC. | Clinic/Center | 853 N Emerson Ave Ste F, Greenwood, IN 46143-5676 | 2020-08-27 |
1518528579 | Johnson Nichols Health Clinic, Inc. | Clinic/Center | 390 Erie Ave Ste A, Connersville, IN 47331-3177 | 2019-06-21 |
1932677291 | Pure Life Clinic LLC | Clinic/Center | 4725 Statesmen Dr Ste B, Indianapolis, IN 46250-5645 | 2018-11-05 |
1417479247 | Crown Radiology Associates | Clinic/Center | 5363 Commerce Blvd Ste A, Crown Point, IN 46307-5325 | 2017-07-13 |
1346634946 | Healthworks Med Group of Indiana P C | Clinic/Center | 6620 Network Way, Indianapolis, IN 46278-1686 | 2015-03-23 |
1477970440 | American Health Network of Indiana, LLC | Clinic/Center | 2625 N Morton St, Kyb Health and Wellness Clinic, Franklin, IN 46131-8820 | 2014-03-27 |
1952626715 | K & D Medical Services | Clinic/Center | 425 Joliet St Ste 125, Dyer, IN 46311-1775 | 2010-04-05 |
1407179559 | Forensic Nursing Specialties, Inc | Clinic/Center | 2270 Lake Ave, Suite 201, Fort Wayne, IN 46805-5359 | 2010-03-03 |
1235372277 | Lagrange Surgery Center, LLC | Clinic/Center | 2500 Ventura Way, Lagrange, IN 46761 | 2009-04-07 |
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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.