| Medicine Reimagined Dpc | |
|
1720 W Lincoln Ave Goshen IN 46526-5906 | |
| (574) 319-1420 | |
| Not Available |
| Full Name | Medicine Reimagined Dpc |
|---|---|
| Speciality | Family Medicine |
| Location | 1720 W Lincoln Ave, Goshen, Indiana |
| Authorized Official Name and Position | Kimberly Stuckey-schrock (MANAGER) |
| Authorized Official Contact | 5743191420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medicine Reimagined Dpc 511 N Greene Rd Goshen IN 46526-1309 Ph: (574) 319-1420 | Medicine Reimagined Dpc 1720 W Lincoln Ave Goshen IN 46526-5906 Ph: (574) 319-1420 |
| NPI Number | 1891375275 |
|---|---|
| Provider Enumeration Date | 04/10/2021 |
| Last Update Date | 05/05/2021 |
| Medicare PECOS PAC ID | 0143639666 |
|---|---|
| Medicare Enrollment ID | O20210512001938 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891375275 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Steven D Schrock |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790891224 PECOS PAC ID: 2062406184 Enrollment ID: I20050805000227 |
| Provider Name | Kimberly Sue Stuckey-schrock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457467995 PECOS PAC ID: 1052340528 Enrollment ID: I20050805000302 |
| Provider Name | Sarah Webber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063022754 PECOS PAC ID: 6002221991 Enrollment ID: I20210301000505 |
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