Elkhart Clinic, LLC

Primary specialty

Pain Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084P2900X

Legal business name

ELKHART CLINIC, LLC

Practice address

6915 N Fir Rd
Granger, IN 46530-4754

Phone

(574) 296-3200

NPI assigned

Nov 29, 2023

Organization subpart

Yes

Parent organization

ELKHART CLINIC, LLCAs reported in NPPES

Name

Megan Leigh Carlson

Title

Credentialing

Phone

(574) 296-3991

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

• Elkhart Clinic, LLC

  • Clinic/Center
  • Elkhart, IN
  • NPI 1073181335
  NPPES parent name

Tax ID family

Elkhart Clinic5 organizations share this tax ID, including this one

Part of

Elkhart Clinic

Other organizations with this tax ID 4

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

• Privia Medical Group Indiana, LLC

  • Multi-Specialty Clinic/Center
  • Elkhart, IN
  • NPI 1215567003
  NPD tax ID
• Privia Medical Group Indiana, LLC

  • Family Nurse Practitioner
  • Wakarusa, IN
  • NPI 1568147809
  NPD tax ID
• Privia Medical Group Indiana, LLC

  • Multi-Specialty Clinic/Center
  • Elkhart, IN
  • NPI 1730638990
  NPD tax ID
• Privia Medical Group Indiana, LLC

  • Family Medicine Physician
  • Elkhart, IN
  • NPI 1982846010
  NPD tax ID

• Elkhart Clinic Pain Medicine Fir Rd Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 29, 2023.

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1689440893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778985",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606778985",
            "telephone_number": "574-296-3990",
            "fax_number": "574-296-3392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6915 N FIR RD",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465304754",
            "telephone_number": "574-296-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKHART CLINIC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELKHART CLINIC, LLC",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "574-296-3991"
    },
    "taxonomies": [
        {
            "code": "2084P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elkhart Clinic Pain Medicine Fir Rd",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ear, Nose and Throat of Michiana P.C.
• Kelley Marie Edelbrock, M.A. CCC-SLP
• Melanie Jean Edmondson, ST
• Scott Brian Edwards, M.D.
• Victoria R Eichorn, NP
• Elkhart General Hospital, Inc.
• Michael Eltzroth, RPH
• Elysian Corp
• Emeritus Corporation
• Emeritus Corporation

• All providers in Granger, IN
• Pain Medicine (Psychiatry & Neurology) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.