NPIMap

Organization Active NPI

Oaklawn Psychiatric Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Elkhart, IN
National Provider Identifier
1598847212
Registry record updated Aug 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
409-0-CMHC Issued in IN
Legal business name
OAKLAWN PSYCHIATRIC CENTER, INC.
Practice address
2600 Oakland Ave
Elkhart, IN 46517-1533
Phone
(574) 533-1234
Fax
(574) 537-2652
NPI assigned
Oct 20, 2006
Last updated
Aug 17, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
OAKLAWN PSYCHIATRIC CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 17, 2011

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

Authorized official

Name
Lynn J. Miller
Title
V.P. - Finance, C.F.O.
Phone
(574) 533-1234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 409-0-CMHC IN Primary

Addresses

Primary practice location

2600 Oakland Ave
Elkhart, IN 46517-1533

Mailing address

330 Lakeview Dr
Goshen, IN 46528-9365
Phone (574) 533-1234

Other identifiers 5

IdentifierTypeStateIssuer
000000097755OtherINBLUE CROSS
CB2281OtherINRAILROAD MEDICARE
100111390MedicaidIN
351OtherINCHAMPUS
DB1691OtherINRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040419000647 IN Part B Supplier - Clinic/Group Practice 6002801065 Receives reassigned benefits from 120 practitioners
Practice locations: Elkhart, IN; Goshen, IN; Mishawaka, IN; South Bend, IN
O20040507000706 IN Part B Supplier - Clinic/Group Practice 6002801065 Receives reassigned benefits from 4 practitioners
Practice locations: Elkhart, IN; Goshen, IN; South Bend, IN
O20050505001204 IN Part B Supplier - Clinic/Group Practice 6002801065 Receives reassigned benefits from 5 practitioners
Practice locations: Elkhart, IN; Goshen, IN; South Bend, IN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Oaklawn Psychiatric Ctr8 organizations share this tax ID, including this one
Part of
Oaklawn Psychiatric Ctr

Other organizations with this tax ID 7

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

Interoperability endpoints

  • Direct secure messaging: nurse.elkhart@direct.oaklawn.org
  • Direct secure messaging: nurse.goshen@direct.oaklawn.org
  • Direct secure messaging: nurse.southbend@direct.oaklawn.org

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 183

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.

View all 183

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313539200000",
    "number": "1598847212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 LAKEVIEW DR",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465289365",
            "telephone_number": "574-533-1234",
            "fax_number": "574-537-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 OAKLAND AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465171533",
            "telephone_number": "574-533-1234",
            "fax_number": "574-537-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKLAWN PSYCHIATRIC CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OAKLAWN PSYCHIATRIC CENTER, INC.",
        "enumeration_date": "2006-10-20",
        "last_updated": "2011-08-17",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "V.P. - FINANCE, C.F.O.",
        "authorized_official_telephone_number": "574-533-1234"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IN",
            "license": "409-0-CMHC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000000097755",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB2281",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100111390",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "351",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB1691",
            "state": "IN"
        }
    ],
    "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 Aug 17, 2011; 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.