OrganizationActive
Privia Medical Group Indiana, LLC
NPI 1083165708 · Multi-Specialty Clinic/Center · Elkhart, IN
Provider details
- NPI number
- 1083165708
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Thomas Vandergrift, Ceo(574) 296-3200
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
2222 W Lexington Ave
Suite B
Elkhart, IN 46514-1420
Phone: (574) 296-3200
Fax: (574) 296-3392
Approximate (ZIP-level) locationGet directions
Mailing address
303 S Nappanee St
Elkhart, IN 46514-2066
Other names (DBA / former)
- Other name
- Elkhart Clinic
Registry dates
- Enumerated
- 2016-10-18
- Last updated
- 2025-05-12
- Certified
- 2025-05-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.