HEALTHSTAT ONSITE CLINIC KEIHIN MUNCIE
NPI 1104280064
Preventive Medicine - Preventive Medicine/Occupational Environmental Medicine in Muncie, IN

Q: What is Healthstat Onsite Clinic Keihin Muncie's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Preventive Medicine/Occupational Environmental Medicine, with taxonomy code 2083P0500X.

Active since April 07, 2016CLIA 15D2113113 · Waiver

4400 N SUPERIOR DR, MUNCIE, IN 47303(657) 282-0951 Get Directions Write a Review

NPPES record last updated: November 28, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 28, 2022, Nov 23, 2022 (2 updates tracked since 2022).

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About Healthstat Onsite Clinic Keihin Muncie NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEALTHSTAT ONSITE CLINIC KEIHIN MUNCIE (NPI 1104280064) is a healthcare organization registered as a preventive medicine/occupational environmental medicine in Muncie, Indiana and active in the NPI registry since April 2016. The organization holds a CLIA Waiver certificate valid through May 16, 2028 and lists Jill Patton, Director Of Risk Management, as its authorized official.

NPPES Registry Identity

NPI1104280064

Entity TypeOrganization

Primary Taxonomy2083P0500X

Legal Business NameHEALTHSTAT ONSITE CLINIC KEIHIN MUNCIE

Location Address4400 N SUPERIOR DRMuncie, IN 47303-6436

Mailing Address4651 Charlotte Park Dr, Suite 300Charlotte, NC 28217-1956

Phone(657) 282-0951

Organization SubpartNo

Authorized OfficialJill PattonDirector Of Risk Management · (704) 529-6161

Enumeration DateApril 7, 2016

Last NPPES UpdateNovember 28, 20222 updates tracked since enumeration

NPPES CertifiedNovember 28, 2022

✔ NPI 1104280064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPreventive Medicine · Preventive Medicine/Occupational Environmental MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2083P0500X

Definition

A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions.

4400 N SUPERIOR DR, Muncie, IN 47303

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D2113113

Healthstat Onsite Clinic Keihin-Muncie · Muncie, IN

Active · expires May 16, 2028

CLIA Number15D2113113

Laboratory TypeChronic Mgt Clinic

Certificate Effective DateMay 17, 2026

Certificate Expiration DateMay 16, 2028

Laboratory DirectorJentry O Daniel

Laboratory Phone(765) 282-0951

Laboratory LocationHealthstat Onsite Clinic Keihin-Muncie4400 N Superior Drive, Muncie, IN 47303

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Healthstat Onsite Clinic Keihin Muncie's NPI number?

The NPI number for Healthstat Onsite Clinic Keihin Muncie is 1104280064. It was assigned to this organization in the NPPES registry on April 7, 2016.

Where is Healthstat Onsite Clinic Keihin Muncie located?

Healthstat Onsite Clinic Keihin Muncie is located at 4400 N Superior Dr, Muncie, IN 47303. The listed phone number is (657) 282-0951.

What is Healthstat Onsite Clinic Keihin Muncie's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Preventive Medicine/Occupational Environmental Medicine, with taxonomy code 2083P0500X.

Does Healthstat Onsite Clinic Keihin Muncie hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2113113) is associated with this NPI, valid through May 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Healthstat Onsite Clinic Keihin Muncie was last updated on November 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.