Active NPI
Thomas Edmund Kreider, MD
- Psychiatry Physician
- Goshen, IN
National Provider Identifier
1093770547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 01051361
- Practice address
- 213 Middlebury St
Goshen, IN 46528-2956 - Phone
- (574) 534-3300
- Fax
- (574) 534-5412
- NPI assigned
- Apr 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 01051361 | IN | Primary |
Addresses
Primary practice location
213 Middlebury St
Goshen, IN 46528-2956
Mailing address
213 Middlebury St
Goshen, IN 46528-2956
Phone (574) 534-0088
Other practice location 1
808 N 3rd St
Goshen, IN 46528-7100
Phone (574) 534-0088
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200249480A | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tkreider299548@direct.ochin.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01051361 | IN | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maple City Health Care Center, Inc. | Current | Accepting new patients | |
| Behavioral Healthcare Consultants, P.C. | Past | Accepting new patients | |
| Major Hospital | Past | Accepting new patients | |
| Community Health Network, Inc. | Past | Accepting new patients | |
| Community Health Network, Inc | Past | Accepting new patients |
Locations
213 Middlebury St
Goshen, IN 46528
Phone (574) 534-0088
808 N 3rd St
Goshen, IN 46528
Phone (574) 534-0088
Interoperability endpoints
- tkreider299548@direct.ochin.org
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Goshen, IN
- NPI 1033166095
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Indianapolis, IN
- NPI 1922336262
-
- Psychiatric Hospital Unit
- Indianapolis, IN
- NPI 1679545966
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
-
- Psychologist
- Lancaster, PA
- NPI 1407831027
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609372800000",
"number": "1093770547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 MIDDLEBURY ST",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465282956",
"telephone_number": "574-534-0088",
"fax_number": "574-534-5412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "213 MIDDLEBURY ST",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465282956",
"telephone_number": "574-534-3300",
"fax_number": "574-534-5412"
}
],
"practiceLocations": [
{
"address_1": "808 N 3rd St",
"address_purpose": "LOCATION",
"city": "Goshen",
"state": "IN",
"postal_code": "465287100",
"country_code": "US",
"telephone_number": "574-534-0088",
"fax_number": "574-971-8434",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KREIDER",
"first_name": "THOMAS",
"middle_name": "EDMUND",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-19",
"last_updated": "2020-12-31",
"certification_date": "2020-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IN",
"license": "01051361",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200249480A",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tkreider299548@direct.ochin.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "213 Middlebury St",
"city": "Goshen",
"state": "IN",
"country_code": "US",
"postal_code": "465282956",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Goshen, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.