NPIMap

Organization Active NPI

Goshen Health System, Inc

  • Family Medicine Physician
  • Middlebury, IN
National Provider Identifier
1477394286
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GOSHEN HEALTH SYSTEM, INC
Practice address
56853 Northridge Dr
Middlebury, IN 46540-9536
Phone
(574) 825-2211
Fax
(574) 825-2212
NPI assigned
Jun 5, 2024
Last updated
Jun 5, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
GOSHEN PHYSICIANSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Authorized official

Name
Jonathan J Yoder
Title
Vice President
Phone
(574) 364-2560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

56853 Northridge Dr
Middlebury, IN 46540-9536

Mailing address

56853 Northridge Dr
Middlebury, IN 46540-9536
Phone (574) 825-2211

Other names 1

  • Middlebury Community Schools Onsite Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Goshen Health System Inc34 organizations share this tax ID, including this one
Part of
Goshen Health System Inc

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Locations

56853 Northridge Dr
Middlebury, IN 46540
Phone (574) 825-2211

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": "1717545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1477394286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56853 NORTHRIDGE DR",
            "city": "MIDDLEBURY",
            "state": "IN",
            "postal_code": "465409536",
            "telephone_number": "574-825-2211",
            "fax_number": "574-825-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56853 NORTHRIDGE DR",
            "city": "MIDDLEBURY",
            "state": "IN",
            "postal_code": "465409536",
            "telephone_number": "574-825-2211",
            "fax_number": "574-825-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOSHEN HEALTH SYSTEM, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOSHEN PHYSICIANS",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "YODER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "574-364-2560"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Middlebury Community Schools Onsite Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Middlebury, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.