CALVARY ASSEMBLY OF GOD OF DEMOTTE, INC. (NPI# 1306453626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306453626 |
| Entity Type | Organization |
| Organization Name | CALVARY ASSEMBLY OF GOD OF DEMOTTE, INC. |
| Practice Address |
1317 15th St. Se Demotte IN 46310-9393 |
| Mailing Address |
1317 15th St Se Demotte IN 46310 |
| Practice Telephone | 2199874280 |
| Mailing Telephone | 2199874280 |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | JAMES CLARK (PRESIDENT) |
| Authorized Official Telephone | 2199874280 |
| Is Organization Subpart | Y |
| Parent Organization Name | CALVARY ASSEMBLY OF GOD OF DEMOTTE, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Connection Medical Clinic | Doing Business As Name - Organization |
| Street Address |
1317 15TH ST. SE |
| City | DEMOTTE |
| State | IN |
| Zip Code | 46310-9393 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447872197 | Mackenna Lee Vandertuin | Early Intervention Provider Agency | 400 11th Circle Se, Demotte, IN 46310 | 2020-05-15 |
| 1316283609 | Jasper County Chiropractic, Inc. | Chiropractor | 701 South Halleck Street, Demotte, IN 46310 | 2012-12-14 |
| 1518136944 | John Joseph Perry | Pharmacist | 915 S Halleck St, Demotte, IN 46310 | 2008-02-29 |
| 1164644498 | Dodi R. Woolley Dds, Inc | Dentist | 534 N Hallock St, Demotte, IN 46310 | 2007-05-03 |
| 1700989233 | Eric J Leestma | Family Medicine | 519 N Halleck, Demotte, IN 46310 | 2006-09-07 |
| 1215960463 | Keener Civil Township Jasper County Ttee | Ambulance | 708 15th St Se, Demotte, IN 46310 | 2006-07-09 |
| 1437187085 | Cecilia Jean Sampsel | Family Medicine | 520 Eighth Ave N.e, Demotte, IN 46310 | 2006-06-30 |
| 1689602468 | Frances Clark | Nurse Practitioner | 11920 W State Rd 10, Demotte, IN 46310 | 2006-06-29 |
| 1336359801 | Donabelle Reyes Eliscupides | Physical Therapist | 10352 N 600 E, Demotte, IN 46310 | 2007-05-23 |
| 1760691638 | Cheryle Rae Lewandowski | Physical Therapy Assistant | 10352 N 600 E, Demotte, IN 46310 | 2007-05-21 |
| Find all providers in zip 46310 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528683919 | Urban Family Care, LLC | Clinic/Center | 336 Augusta Ln, West Lafayette, IN 47906-8721 | 2020-06-11 |
| 1952924896 | W. Lafayette Health Center | Clinic/Center | 2701b Kent Ave, W Lafayette, IN 47906-1350 | 2020-05-27 |
| 1710525175 | Proactive - South Newton | Clinic/Center | 1388 South 50 East, Kentland, IN 47951 | 2019-12-17 |
| 1902443781 | Proactive - Edinburgh Dpc | Clinic/Center | 220 N Pleasant St, Edinburgh, IN 46124-1300 | 2019-11-29 |
| 1063058311 | Proactive - Eastern Pulaski | Clinic/Center | 715 School Dr, Winamac, IN 46996-1584 | 2019-11-21 |
| 1275179541 | Proactive - New Prairie | Clinic/Center | 605 E Michigan St, Rolling Prairie, IN 46371-9576 | 2019-11-21 |
| 1982255667 | Careatc | Clinic/Center | 59427 County Road 13, Elkhart, IN 46517-3503 | 2019-09-24 |
| 1134777824 | Activate Healthcare - Mcoe Clinic | Clinic/Center | 6920 Parkdale Pl Ste 100, Indianapolis, IN 46254-5604 | 2019-08-27 |
| 1457906141 | With Dignity Too LLC | Clinic/Center | 1958 West Boulivard, Kokomo, IN 46902 | 2019-08-08 |
| 1093360059 | Activate Healthcare - Waste Away Grp | Clinic/Center | 1621 W Beardsley Ave, Elkhart, IN 46514-1825 | 2019-08-07 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CALVARY ASSEMBLY OF GOD OF DEMOTTE, INC..
| 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.