Elkhart General Hospital, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

12-005017-1 Issued in IN

Legal business name

ELKHART GENERAL HOSPITAL, INC.

Doing business as

Elkhart General Women's Center

Practice address

600 East Blvd
West Wing
Elkhart, IN 46514-2483

Phone

(574) 523-2751

Fax

(574) 389-4840

NPI assigned

Jul 28, 2006

Last updated

Jul 25, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

ELKHART GENERAL HOSPITAL, INC.As reported in NPPES

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

Authorized official

Name

Mr. C. John Kraft Jr.

Title

Director of Managed Care

Phone

(574) 523-7914

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elkhart General Women's Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Elkhart General Hospital Inc

  dba New Directions Wellness Clinic

  • Medical Specialty Clinic/Center
  • Elkhart, IN
  • NPI 1043317415

  O20031213000004

  Same enrollment
• Elkhart General Hospital, Inc.

  • General Acute Care Hospital
  • Elkhart, IN
  • NPI 1477551489

  O20031213000004

  Same enrollment
• Elkhart General Hospital, Inc.

  dba Women's Center - Continence Clinic

  • Adult Medicine Physician
  • Elkhart, IN
  • NPI 1891922332

  O20031213000004

  Same enrollment

Part of

Elkhart General Hospita

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343174400000",
    "number": "1376557785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1887",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465151887",
            "telephone_number": "574-389-0542",
            "fax_number": "574-522-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 EAST BLVD",
            "address_2": "WEST WING",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142483",
            "telephone_number": "574-523-2751",
            "fax_number": "574-389-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKHART GENERAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELKHART GENERAL HOSPITAL, INC.",
        "enumeration_date": "2006-07-28",
        "last_updated": "2012-07-25",
        "status": "A",
        "authorized_official_last_name": "KRAFT",
        "authorized_official_first_name": "C.",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE",
        "authorized_official_telephone_number": "574-523-7914",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "12-005017-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100114000C",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elkhart General Women's Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Elkhart General Hospital, Inc.
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• Elkhart General Hospital, Inc. (Elkhart General Extended Hour Care and Staffing)

• Specialist in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.