Active NPI
Elkhart General Hospital, Inc.
- Psychiatric Hospital Unit
- Elkhart, IN
National Provider Identifier
1619975554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital Unit
- License
- 05-005017-1
- Legal business name
- ELKHART GENERAL HOSPITAL, INC.
- Practice address
- 600 East Blvd
Elkhart, IN 46514-2483 - Phone
- (574) 523-3200
- Fax
- (574) 389-4860
- NPI assigned
- Jul 13, 2005
- Organization subpart
- Yes
- Parent organization
- ELKHART GENERAL HOSPITAL, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jeffrey Costello
- Title
- Cfo
- Phone
- (574) 674-3460
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | 05-005017-1 | IN | Primary |
Addresses
Primary practice location
600 East Blvd
Elkhart, IN 46514-2483
Mailing address
600 East Blvd
Elkhart, IN 46514-2483
Phone (574) 942-6212
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100268340A | Medicaid | IN |
Other names 1
- Center for Behavioral Medicine
National Provider Directory
National Provider Directory- Part of
- Elkhart General Hos Osc
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121212800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1669852800000",
"number": "1619975554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 EAST BLVD",
"city": "ELKHART",
"state": "IN",
"postal_code": "465142483",
"telephone_number": "574-942-6212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 EAST BLVD",
"city": "ELKHART",
"state": "IN",
"postal_code": "465142483",
"telephone_number": "574-523-3200",
"fax_number": "574-389-4860"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELKHART GENERAL HOSPITAL, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ELKHART GENERAL HOSPITAL, INC.",
"enumeration_date": "2005-07-13",
"last_updated": "2022-12-01",
"certification_date": "2022-12-01",
"status": "A",
"authorized_official_last_name": "COSTELLO",
"authorized_official_first_name": "JEFFREY",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "574-674-3460",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "273R00000X",
"taxonomy_group": "",
"desc": "Psychiatric Unit",
"state": "IN",
"license": "05-005017-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100268340A",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Center for Behavioral Medicine",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Center for Behavioral Medicine",
"code": "3",
"type": "Doing Business As"
}
]
}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 Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.