ELKHART CLINIC, LLC (NPI# 1902416076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902416076 |
| Entity Type | Organization |
| Organization Name | ELKHART CLINIC, LLC |
| Practice Address |
2240 Karisa Dr Ste 1 Goshen IN 46526-6943 |
| Mailing Address |
Po Box 2968 Elkhart IN 46515-2968 |
| Practice Telephone | 5742963200 |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2020-08-04 |
| Authorized Official Name | DR. TIMOTHY PORSCHE (MANAGING PARTNER) |
| Authorized Official Telephone | 5742963200 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | ELKHART CLINIC, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Surgery Goshen Office of Elkhart Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1962788141 | Elkhart Clinic, LLC | Clinic/Center | 2120 Rieth Blvd, Suite A, Goshen, IN 46526-5843 | 2011-11-01 |
| Street Address |
2240 KARISA DR STE 1 |
| City | GOSHEN |
| State | IN |
| Zip Code | 46526-6943 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790705655 | John Peralo | Surgery | 30 Hatfield Ln Ste 107, Goshen, NY 10924-6768 | 2006-07-20 |
| 1396727020 | Jon E Smucker | Surgery | 101 Marilyn Ave, Suite 4, Goshen, IN 46526-4800 | 2005-11-17 |
| 1538152392 | Gerig Surgical Associates PC | Surgery | 2006 S Main St, Suite A, Goshen, IN 46526-5232 | 2005-08-26 |
| 1215435458 | Brittany N Hembree | Surgery | 2006 S Main St Ste A, Goshen, IN 46526-5232 | 2018-01-23 |
| 1649681321 | Michael Minarich | Surgery | 200 High Park Ave, Goshen, IN 46526-4810 | 2014-05-15 |
| 1710286174 | Naureen Iqbal | Surgery | 200 High Park Ave, Goshen, IN 46526 | 2011-03-23 |
| 1528224300 | Ashley Nicole Hardy | Surgery | 200 High Park Ave, Goshen, IN 46526-4810 | 2008-07-31 |
| 1740457936 | Urs W Von Holzen | Surgery | 200 High Park Ave, Goshen, IN 46526-4810 | 2008-05-15 |
| 1093823908 | Goshen Surgical Associates, Inc. | Surgery | 101 Marilyn Ave, Suite 4, Goshen, IN 46526-4800 | 2006-08-29 |
| 1649252388 | John W Harley | Surgery | 101 Marilyn Ave, Suite 4, Goshen, IN 46526-4800 | 2005-11-17 |
| 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.