Individual provider Active NPI

Jay Lynn Schlabach, MD

  • Adult Medicine Physician
  • Goshen, IN
National Provider Identifier
1710053020
Registry record updated Jul 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
01032927A Issued in IN
Practice address
400 W Lincoln Ave
Goshen, IN 46526-2413
Phone
(574) 533-7600
Fax
(574) 533-7666
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 01032927A IN Primary

Addresses

Primary practice location

400 W Lincoln Ave
Goshen, IN 46526-2413

Mailing address

400 W Lincoln Ave
Goshen, IN 46526-2413
Phone (574) 533-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01032927AINMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mohci Urgent Care LLC Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jschlabach18323@elrio.direct.ci.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311552000000",
    "number": "1710053020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W LINCOLN AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465262413",
            "telephone_number": "574-533-7600",
            "fax_number": "574-533-7666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W LINCOLN AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465262413",
            "telephone_number": "574-533-7600",
            "fax_number": "574-533-7666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLABACH",
        "first_name": "JAY",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2011-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IN",
            "license": "01032927A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; 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.