Black Clover Holdings LLC
NPI 1063397867 · General Practice Physician · Granger, IN
Black Clover Holdings LLC is a General Practice Physician organization in Granger, IN (NPI 1063397867).
Provider details
- NPI number
- 1063397867
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Joshua Lederer, Partner(574) 369-9102
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Medi Weight Loss Mishawaka
Registry dates
- Enumerated
- 2025-08-11
- Last updated
- 2025-08-11
- Certified
- 2025-08-10
Frequently asked questions
- What is Black Clover Holdings LLC's NPI number?
- Black Clover Holdings LLC's National Provider Identifier (NPI) is 1063397867, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Black Clover Holdings LLC?
- Black Clover Holdings LLC is classified in the NPPES registry as General Practice Physician (Allopathic & Osteopathic Physicians).
- Where is Black Clover Holdings LLC located?
- Black Clover Holdings LLC's practice location on file with NPPES is 7225 Heritage Square Dr Ste 240, Granger, IN 46530-5646.
- What is Black Clover Holdings LLC's phone number?
- The practice phone number listed in the NPPES registry for Black Clover Holdings LLC is (574) 369-9102.
- Who is the authorized official for Black Clover Holdings LLC?
- The authorized official listed on Black Clover Holdings LLC's NPPES record is Joshua Lederer, Partner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Black Clover Holdings LLC's NPI active?
- Yes — Black Clover Holdings LLC's NPI (1063397867) is active in the NPPES registry as of the last update on 2025-08-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.