Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Privia Medical Group Indiana, LLC

Organization Multi-Specialty Clinic/Center · NPI 1013912286

Privia Medical Group Indiana, LLC is a Multi-Specialty Clinic/Center in Elkhart, Indiana. Licensed in Indiana. Registered with an NPI since 2005.

Licensed in
IN
In the registry since
2005
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

303 S Nappanee St
Elkhart, IN 46514-2066
Phone: (574) 296-3200
Fax: (574) 296-3392
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X (IN)

Record details

NPI number1013912286
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Thomas Vandergrift — Chief Executive Administrator · (574) 296-3200
NPI enumeratedJune 15, 2005
Last updated in NPPESApril 17, 2025
Certification dateApril 17, 2025
Mailing addressPo Box 778985, Chicago, IL 60677-8985

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