NPIMap

Organization Active NPI

Goshen Health System, Inc

  • Pediatrics Physician
  • Goshen, IN
National Provider Identifier
1720829237
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GOSHEN HEALTH SYSTEM, INC
Doing business as
Goshen Physicians
Goshen Physicians Pediatrics
Practice address
1852 Ashburn Dr
Goshen, IN 46526-6537
Phone
(574) 533-5808
Fax
(574) 534-7215
NPI assigned
Jun 6, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Authorized official

Name
Jonathan J Yoder
Title
VP
Phone
(574) 364-2560

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1852 Ashburn Dr
Goshen, IN 46526-6537

Mailing address

PO Box 834
Goshen, IN 46527-0834

Other names 2

  • Goshen Physicians Doing business as
  • Goshen Physicians Pediatrics Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0873657Goshen Pediatrics1852 Ashburn Dr, Goshen, IN 46526Provider-performed microscopyJul 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
Goshen Health System34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

Locations

1824 Dorchester Ct
Ste A
Goshen, IN 46526
Phone (574) 534-2548

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1720829237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 834",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465270834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1852 ASHBURN DR",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465266537",
            "telephone_number": "574-533-5808",
            "fax_number": "574-534-7215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOSHEN HEALTH SYSTEM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "YODER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "574-364-2560"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goshen Physicians",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Goshen Physicians Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.