Elkhart General Hospital, Inc.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

09-005017-1 Issued in IN

Legal business name

ELKHART GENERAL HOSPITAL, INC.

Doing business as

Women's Center - Continence Clinic

Practice address

600 East Blvd
Women's Center - Continence Clinic
Elkhart, IN 46514-2483

Phone

(574) 523-2751

Fax

(574) 389-4840

NPI assigned

Jun 11, 2009

Last updated

Jun 27, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

ELKHART GENERAL HOSPITAL, INC.As reported in NPPES

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

Authorized official

Name

Mr. C. John Kraft Jr.

Title

Director of Managed Care

Phone

(574) 523-7914

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Women's Center - Continence Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Elkhart General Hospital Inc

  dba New Directions Wellness Clinic

  • Medical Specialty Clinic/Center
  • Elkhart, IN
  • NPI 1043317415

  O20031213000004

  Same enrollment
• Elkhart General Hospital, Inc.

  dba Elkhart General Women's Center

  • Specialist
  • Elkhart, IN
  • NPI 1376557785

  O20031213000004

  Same enrollment
• Elkhart General Hospital, Inc.

  • General Acute Care Hospital
  • Elkhart, IN
  • NPI 1477551489

  O20031213000004

  Same enrollment

Part of

Elkhart General HSP Dba

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309132800000",
    "number": "1891922332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1887",
            "address_2": "ELKHART GENERAL PHYSICIAN SERVICES",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465151887",
            "telephone_number": "574-389-0542",
            "fax_number": "574-522-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 EAST BLVD",
            "address_2": "WOMEN'S CENTER - CONTINENCE CLINIC",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142483",
            "telephone_number": "574-523-2751",
            "fax_number": "574-389-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKHART GENERAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELKHART GENERAL HOSPITAL, INC.",
        "enumeration_date": "2009-06-11",
        "last_updated": "2011-06-27",
        "status": "A",
        "authorized_official_last_name": "KRAFT",
        "authorized_official_first_name": "C.",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE",
        "authorized_official_telephone_number": "574-523-7914",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IN",
            "license": "09-005017-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100114000E",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Women's Center - Continence Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Elkhart General Hospital, Inc. (Elkhart Cardiology Diagnostics)
• Elkhart Neurology PC
• Elkhart Ophthalmology, LLC
• Elkhart Oral and Maxillofacial Surgery Inc.
• Elkhart Pediatric Dentistry LTD

• Adult Medicine Physician in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Adult Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.