NPIMap

Organization Active NPI

Community Occupational Medicine, LLC

  • Occupational Medicine Clinic/Center
  • Elkhart, IN
National Provider Identifier
1902269889
Registry record updated Mar 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X
License
28193462A Issued in IN
Legal business name
COMMUNITY OCCUPATIONAL MEDICINE, LLC
Practice address
22818 Old US 20
Elkhart, IN 46516-9150
Phone
(574) 389-1231
Fax
(574) 389-1232
NPI assigned
Mar 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2016

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

Authorized official

Name
Aimee Weiss, RT
Title
Practice Manager
Phone
(574) 389-1231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Clinic/Center 261QX0100X 28193462A IN Primary

Addresses

Primary practice location

22818 Old US 20
Elkhart, IN 46516-9150

Mailing address

22818 Old US 20
Elkhart, IN 46516-9150
Phone (574) 389-1231

National Provider Directory

National Provider Directory
Tax ID family
Beacon Occupational Health LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459296000000",
    "number": "1902269889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22818 OLD US 20",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169150",
            "telephone_number": "574-389-1231",
            "fax_number": "574-389-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22818 OLD US 20",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169150",
            "telephone_number": "574-389-1231",
            "fax_number": "574-389-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY OCCUPATIONAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-30",
        "last_updated": "2016-03-30",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "AIMEE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "574-389-1231",
        "authorized_official_credential": "RT"
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "IN",
            "license": "28193462A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; 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.