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

Last updated

Nov 29, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

ELKHART CLINIC, LLCAs reported in NPPES

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

Authorized official

Name

Megan Leigh Carlson

Title

Credentialing

Phone

(574) 296-3991

Specialties & licenses 1

Addresses

Other names 1

• Elkhart Clinic Pain Medicine Fir Rd Other name

Tax ID family

Elkhart Clinic LLC5 organizations share this tax ID, including this one

Part of

Elkhart Clinic LLC

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

  dba Elkhart Family Physicians

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

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.

• Elkhart Clinic, LLC

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

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

{
    "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. (Campbell Ear, Nose and Throat)
• Kelley Marie Edelbrock, M.A. CCC-SLP
• Melanie Jean Edmondson, ST
• Scott Brian Edwards, M.D.
• Victoria R Eichorn, NP
• Elkhart General Hospital, Inc. (Quality Care Pediatrics)
• Michael Eltzroth, RPH
• Elysian Corp (Elysian Center for Health and Wellness)
• Emeritus Corporation (Emeritus at Arborwood)
• Emeritus Corporation (Brookdale Granger)

• Pain Medicine (Psychiatry & Neurology) Physician in Granger, IN
• Providers in Granger, IN by specialty
• 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.