Organization Active NPI

Internal Medicine of the Wabash Valley P.C.

  • Internal Medicine Physician
  • Terre Haute, IN
National Provider Identifier
1356727218
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
02002047 Issued in IN
Legal business name
INTERNAL MEDICINE OF THE WABASH VALLEY P.C.
Practice address
2223 Wabash Ave
Terre Haute, IN 47807-3305
Phone
(812) 235-7252
Fax
(812) 235-7176
NPI assigned
Aug 3, 2015
Last updated
Aug 25, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Authorized official

Name
Dr. Jon Lee Stockrahm, D.O., CMDNPI 1962409466
Title
President
Phone
(812) 235-7252

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 02002047 IN Primary

Addresses

Primary practice location

2223 Wabash Ave
Terre Haute, IN 47807-3305

Mailing address

2223 Wabash Ave
Terre Haute, IN 47807-3305
Phone (812) 235-7252

Other identifiers 1

IdentifierTypeStateIssuer
200227720AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150807013317 IN Part B Supplier - Clinic/Group Practice 8123332913 Receives reassigned benefits from 1 practitioner
Practice locations: Terre Haute, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0958708Internal Medicine of the Wabash Valley PC2223 Wabash Ave, Terre Haute, IN 47807Provider-performed microscopyJan 9, 2028

National Provider Directory

National Provider Directory

Locations

1600 E Springhill Dr
Terre Haute, IN 47802
Phone (812) 235-7252

2223 Wabash Ave
Terre Haute, IN 47807
Phone (812) 235-7252

2800 Poplar St
Ste 19A
Terre Haute, IN 47803
Phone (812) 235-7252

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787616000000",
    "number": "1356727218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 WABASH AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478073305",
            "telephone_number": "812-235-7252",
            "fax_number": "812-235-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 WABASH AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478073305",
            "telephone_number": "812-235-7252",
            "fax_number": "812-235-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE OF THE WABASH VALLEY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-03",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A",
        "authorized_official_last_name": "STOCKRAHM",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-235-7252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O., CMD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02002047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200227720A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.