NPIMap

Organization Active NPI

Maple City Health Care Center, Inc

Doing business as Maple City Dental

  • Federally Qualified Health Center (FQHC)
  • Goshen, IN
National Provider Identifier
1588209142
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MAPLE CITY HEALTH CARE CENTER, INC
Doing business as
Maple City Dental
Practice address
814 N 3Rd St
Goshen, IN 46528-2632
Phone
(574) 534-0088
NPI assigned
Nov 7, 2019
Last updated
Sep 28, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
MAPLE CITY HEALTH CARE CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Authorized official

Name
Karen Miller Rush
Title
Director of Finance
Phone
(574) 534-0088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

814 N 3Rd St
Goshen, IN 46528-2632

Mailing address

213 Middlebury St
Goshen, IN 46528-2956

Other names 1

  • Maple City Dental Doing business as

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
15D2207537Maple City Dental814 N 3Rd Street, Goshen, IN 46528Certificate of waiverDec 28, 2026

National Provider Directory

National Provider Directory
Tax ID family
Maple City Health Care4 organizations share this tax ID, including this one
Part of
Maple City Health Care

Other organizations with this tax ID 3

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

Locations

814 N 3rd St
Goshen, IN 46528
Phone (574) 500-3737

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

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": "1573084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1588209142",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 N 3RD ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465282632",
            "telephone_number": "574-534-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE CITY HEALTH CARE CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAPLE CITY HEALTH CARE CENTER, INC",
        "enumeration_date": "2019-11-07",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-25",
        "status": "A",
        "authorized_official_last_name": "RUSH",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "MILLER",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "574-534-0088"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maple City Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maple City Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.