ELKHART CLINIC, LLC (NPI# 1467603746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467603746 |
| Entity Type | Organization |
| Organization Name | ELKHART CLINIC, LLC |
| Other Organization Name | EDISON LAKES UROLOGY - MICHIGAN OFFICE |
| Practice Address |
804 E Front St Buchanan MI 49107-1444 |
| Mailing Address |
Po Box 2968 Elkhart IN 46515-2968 |
| Practice Telephone | 5748555800 |
| Practice Fax Number | 5748555805 |
| Mailing Telephone | 5748555800 |
| Mailing Fax Number | 5748555805 |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2008-10-06 |
| Authorized Official Name | 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 |
| Other Name | Type Code |
|---|---|
| Edison Lakes Urology - Michigan Office | Doing Business As Name - Organization |
| 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 |
804 E FRONT ST |
| City | BUCHANAN |
| State | MI |
| Zip Code | 49107-1444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457313926 | Harold E Brown | Family Medicine | 804 E Front St, Buchanan, MI 49107-1444 | 2006-04-03 |
| 1487036869 | Beacon Medical Group, Inc. | Family Medicine | 804 E Front St, Buchanan, MI 49107-1444 | 2015-06-23 |
| 1851592935 | Michiana Urology PC | Urology | 804 E Front St, Buchanan, MI 49107-1444 | 2007-05-29 |
| 1265488142 | Harold Brown Md | Family Medicine | 804 E Front St, Buchanan, MI 49107-1444 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447453188 | Ronald C Carr | Dentist | 802 East Front St, Ste 5, Buchanan, MI 49107 | 2007-06-08 |
| 1669696464 | Barbara A Starke | Registered Nurse | 804 E Front Street, Buchanan, MI 49107 | 2007-04-12 |
| 1558338368 | Respiratory Home Care & Convalescent Supply Inc | Durable Medical Equipment & Medical Supplies | 320 N Redbud Trail, Buchanan, MI 49107 | 2006-03-01 |
| 1255827382 | Kari Mitchell-coplen | Physical Therapy Assistant | 500 E 3rd St, Buchanan, MI 49107 | 2018-07-01 |
| 1790294064 | Red Bud Health Services LLC | Physical Therapist | 500 E 3rd St, Buchanan, MI 49107 | 2017-09-29 |
| 1457743486 | Audrey Lynn Carrier | Family Medicine | 1045 E Front St, Buchanan, MI 49107 | 2015-02-27 |
| 1740801653 | Sharon M Bradley | Nursing Care | 324 N Detroit St, Buchanan, MI 49107-1204 | 2020-05-01 |
| 1235526260 | Into His Rest Ministries | Social Worker | 102 Elizabeth St, Buchanan, MI 49107-1327 | 2015-04-16 |
| 1851443956 | Drs Steven and Brenda Smoke Od PC | Optometrist | 400 E Front St, Suite A, Buchanan, MI 49107-1403 | 2007-01-17 |
| 1306998919 | Brenda Dani Smoke | Optometrist | 400 E Front St Ste A, Buchanan, MI 49107-1403 | 2007-01-17 |
| Find all providers in zip 49107 | ||||
| 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 |
|---|---|---|---|---|
| 1851592935 | Michiana Urology PC | Urology | 804 E Front St, Buchanan, MI 49107-1444 | 2007-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477488 | Munson Healthcare Charlevoix Hospital | Urology | 11695 Park Ave, Suite A, Charlevoix, MI 49720 | 2020-11-06 |
| 1396235610 | Munson Medical Center | Urology | 405 N Division Rd Ste 2, Petoskey, MI 49770-9046 | 2018-05-11 |
| 1770072498 | Bellin Health Iron Mountain Inc | Urology | 1005 S Hemlock St Ste B, Iron Mountain, MI 49801-3854 | 2018-05-08 |
| 1205215621 | Alexander David Tapper | Urology | 44200 Woodward Ave Ste 207, Pontiac, MI 48341-5045 | 2015-05-19 |
| 1912324211 | Boston Medical Group, P.C. | Urology | 24901 Northwestern Hwy., Suite 615, Southfield, MI 48075 | 2014-03-25 |
| 1548600984 | Katie Marie Rosen | Urology | 19991 Hall Rd Ste 201, Macomb, MI 48044 | 2013-06-30 |
| 1609213636 | Arya Khatiwoda | Urology | 2900 Hannah Blvd Ste 104, East Lansing, MI 48823-5380 | 2013-05-31 |
| 1003179730 | Kalen Jacob Rimar | Urology | 130 Town Center Dr Ste 101, Troy, MI 48084 | 2012-06-18 |
| 1780955294 | Harry Nicholas Kotsis | Urology | 265 Touraine Rd, Grosse Pointe Farms, MI 48236-3308 | 2012-01-16 |
| 1750678264 | Michael Kozminski | Urology | 245 Cherry St Se Ste 202, Grand Rapids, MI 49503-4607 | 2011-07-05 |
| 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.