- Practice location
- 1755 Fulton St, Elkhart, IN 46514-1927
- Phone
- 574-294-3030
- Fax
- 574-296-3544
- Last updated
- November 3, 2026
Privia Medical Group Indiana, LLC is a healthcare organization based in Elkhart, IN. Privia Medical Group Indiana, LLC practices in Elkhart, IN. The NPI Number for Privia Medical Group Indiana, LLC is 1013380526. The current practice location address for Privia Medical Group Indiana, LLC is 1755 Fulton St, Elkhart, IN 46514-1927 and can be reached out via phone at 574-294-3030 and via fax at 574-296-3544.
Provider Profile Details
- NPI Number
- 1013380526
- Provider Name
- Privia Medical Group Indiana, LLC
- Provider Entity Type
- Organization
- Address
- 1755 Fulton St, Elkhart, IN 46514-1927
- Phone Number
- 574-294-3030
- Fax Number
- 574-296-3544
- Primary Taxonomy
- Ophthalmology · 207W00000X
- Organization Subpart
- No
- Authorized Official
- Thomas Vandergrift · Ceo · 574-296-3200
- Other Names
- Elkhart Eye Care (Doing Business As)
- Provider Enumeration Date
- November 5, 2015
- Last Update Date
- November 3, 2026
- Certification Date
- November 3, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1755 Fulton St
Elkhart, IN 46514-1927 - City
- Elkhart
- State
- Indiana
- Zip
- 46514-1927
- Phone Number
- 574-294-3030
- Fax Number
- 574-296-3544
Provider Business Mailing Address Details
- Address
- Po Box 39491
Belfast, ME 04915-1248 - City
- Belfast
- State
- ME
- Zip
- 04915-1248
- Phone Number
- 571-982-6636
- Fax Number
- 240-696-1353
License Information
- Taxonomy
- Ophthalmology · 207W00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Privia Medical Group Indiana, LLC?
The NPI number of Privia Medical Group Indiana, LLC is 1013380526. It was assigned on November 5, 2015 and is currently active in the NPPES registry.
What is the specialty of Privia Medical Group Indiana, LLC?
Privia Medical Group Indiana, LLC is registered under the primary taxonomy Ophthalmology (code 207W00000X).
Where does Privia Medical Group Indiana, LLC practice?
The practice location is 1755 Fulton St, Elkhart, IN 46514-1927. The office can be reached at 574-294-3030 (phone) or 574-296-3544 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1013380526 directly on the NPPES registry website.