Individual provider Active NPI

Harley Wayne Yoder, M.D.

  • Family Medicine Physician
  • Elkhart, IN
National Provider Identifier
1821199431
Registry record updated Dec 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01046845 Issued in IN
Practice address
25651 County Road 20
Elkhart, IN 46517-2310
Phone
(574) 522-1201
NPI assigned
Sep 26, 2006
Last updated
Dec 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01046845 IN Primary

Addresses

Primary practice location

25651 County Road 20
Elkhart, IN 46517-2310

Mailing address

25651 County Road 20
Elkhart, IN 46517-2310
Phone (574) 522-1201

Other identifiers 3

IdentifierTypeStateIssuer
200158990MedicaidIN
000000091944OtherINANTHEM
080117323OtherINRAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101108000833 IN Practitioner - Family Practice 3870664261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group Indiana LLCGroup PAC ID 2365341674, 28 clinicians

Practice addresses (Care Compare)

25651 County Rd
Suite 20
Elkhart, IN 46517-2310
Phone (574) 522-1201

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01046845INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Indiana, LLC CurrentSince Jan 1, 2017 Accepting new patients
Privia Medical Group Indiana, LLC CurrentSince Jan 1, 2017 Accepting new patients
Privia Medical Group Indiana, LLC Current Accepting new patients

Locations

25651 County Road 20
Elkhart, IN 46517
Phone (219) 522-1201

303 S Nappanee St
Elkhart, IN 46514

Interoperability endpoints

  • Direct secure messaging: harley.yoder.1@31626.direct.athenahealth.com
  • Direct secure messaging: harley.yoder@elkhartc.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291593600000",
    "number": "1821199431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25651 COUNTY ROAD 20",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465172310",
            "telephone_number": "574-522-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25651 COUNTY ROAD 20",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465172310",
            "telephone_number": "574-522-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YODER",
        "first_name": "HARLEY",
        "middle_name": "WAYNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01046845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200158990",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000091944",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "080117323",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.