John W Harley, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

31690 Issued in IN

Practice address

101 Marilyn Ave
Suite 4
Goshen, IN 46526-4800

Phone

(574) 533-2769

Fax

(574) 534-6822

NPI assigned

Nov 17, 2005

Last updated

Jan 8, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Goshen Surgical Associates, Inc.

  • Vascular Surgery Physician
  • Goshen, IN
  • NPI 1093823908
  NPD (past) Authorized official

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199750400000",
    "number": "1649252388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MARILYN AVE",
            "address_2": "SUITE 4",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264800",
            "telephone_number": "574-533-2769",
            "fax_number": "574-534-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MARILYN AVE",
            "address_2": "SUITE 4",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264800",
            "telephone_number": "574-533-2769",
            "fax_number": "574-534-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARLEY",
        "first_name": "JOHN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2008-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "31690",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "31690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Haimes, M.D.
• Lydia Hall, BCBA
• Tia Hall
• Mohsen Hamadanchi, DC
• Hancock Regional Hospital (Waterford Crossing)
• Stephen David Harmon, MD
• Kallie Harris, FNP-C
• Harrison Township Fire Department
• April Noelle Hart, RN, MSN, FNP-BC, CNE
• Adam Christian Hartman, MSW

• Vascular Surgery Physician in Goshen, IN
• Providers in Goshen, IN by specialty
• Vascular Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; 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.