DR. KIMBERLY SUE STUCKEY SCHROCK (NPI# 1457467995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457467995 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY SUE STUCKEY SCHROCK |
| Credential | M.D. |
| Practice Address |
400 W Lincoln Ave Goshen IN 46526-2413 |
| Practice Telephone | 5745337600 |
| Practice Fax Number | 5745337666 |
| Mailing Telephone | 5745337600 |
| Mailing Fax Number | 5745337666 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2012-11-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 01060332A | IN | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | 01060332A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200526460 | 05 |
| Street Address |
400 W LINCOLN AVE |
| City | GOSHEN |
| State | IN |
| Zip Code | 46526-2413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467094821 | Diana Marmolejos | Registered Nurse | 400 W Lincoln Ave, Goshen, IN 46526-2413 | 2019-10-16 |
| 1083063499 | Cipriana Ortega | Nurse Practitioner | 400 W Lincoln Ave, Goshen, IN 46526-2413 | 2016-06-07 |
| 1346653334 | Anna Weaver Grady | Family Medicine | 400 W Lincoln Ave, Goshen, IN 46526-2413 | 2014-06-06 |
| 1710053020 | Jay Lynn Schlabach | Family Medicine | 400 W Lincoln Ave, Goshen, IN 46526-2413 | 2006-11-28 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972951945 | Thomas Pechin IIi | Family Medicine | 2014 S Main St Ste A, Goshen, IN 46526-5235 | 2016-05-31 |
| 1760739908 | Chubinidzemd Pllc | Family Medicine | 1306 Old Taylor Trl, Goshen, KY 40026-9727 | 2012-08-07 |
| 1952662777 | Malinda J Lasater | Family Medicine | 2824 Elkhart Rd Ste A, Goshen, IN 46526-1014 | 2012-06-07 |
| 1265609820 | Nicholas D. Belasco | Family Medicine | 1 Hatfield Ln Ste 1b, Goshen, NY 10924-6753 | 2008-05-13 |
| 1467624494 | Brandon Oconnor | Family Medicine | 1 Hatfield Ln Ste 2b, Goshen, NY 10924 | 2008-03-31 |
| 1316160328 | Timothy W Nush | Family Medicine | 2024 Dorchester Ct Ste 1, Goshen, IN 46526-6546 | 2007-04-10 |
| 1710029657 | Chen Nan Ho | Family Medicine | 30979 Road 67, Goshen, CA 93291-9303 | 2007-02-13 |
| 1669566352 | Peter Joseph Cirigliano | Family Medicine | 123 South Church St., Goshen, NY 10924 | 2006-10-03 |
| 1811906084 | Timothy Dwayne Thut | Family Medicine | 1811 Charlton Ct, Goshen, IN 46526-6464 | 2006-08-05 |
| 1508875071 | Douglas Allan Charlesworth | Family Medicine | 2104 W Saybrook Dr, Goshen, IN 46528-5709 | 2006-08-05 |
| Find all providers in GOSHEN | ||||
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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.