Organization Active NPI

River Oaks OB/GYN Associates

  • Obstetrics & Gynecology Nurse Practitioner
  • Elkhart, IN
National Provider Identifier
1215387352
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
28142238A Issued in IN
Legal business name
RIVER OAKS OB/GYN ASSOCIATES
Practice address
2405 W Lexington Ave
Elkhart, IN 46514-1417
Phone
(574) 295-8805
Fax
(574) 522-0039
NPI assigned
Jun 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Vicki A Kronemeyer
Title
Coo
Phone
(574) 295-8805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LX0001X 28142238A IN Primary

Addresses

Primary practice location

2405 W Lexington Ave
Elkhart, IN 46514-1417

Mailing address

2405 W Lexington Ave
Elkhart, IN 46514-1417
Phone (574) 295-8805

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582761600000",
    "number": "1215387352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 W LEXINGTON AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141417",
            "telephone_number": "574-295-8805",
            "fax_number": "574-522-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 W LEXINGTON AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141417",
            "telephone_number": "574-295-8805",
            "fax_number": "574-522-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER OAKS OB/GYN ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-20",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A",
        "authorized_official_last_name": "KRONEMEYER",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "574-295-8805",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "IN",
            "license": "28142238A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.

Verify at the official NPI Registry.