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MEDSTAT LLC
NPI 1437689783
Clinic/Center - Primary Care in Warsaw, IN

Active since June 19, 2017CLIA 15D2038922 · Waiver
1500 PROVIDENT DR STE A, WARSAW, IN 46580(574) 372-7637 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2022, Jun 19, 2017 (2 updates tracked since 2017).

About Medstat Llc NPPES

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

MEDSTAT LLC (NPI 1437689783) is a healthcare organization registered as a primary care in Warsaw, Indiana and active in the NPI registry since June 2017. The organization holds a CLIA Waiver certificate valid through March 27, 2028 and lists Megan Martin, Vice President, as its authorized official.

NPPES Registry Identity

NPI1437689783
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameMEDSTAT LLC
Location Address1500 PROVIDENT DR STE AWarsaw, IN 46580-3297
Mailing Address1500 Provident Dr Ste AWarsaw, IN 46580-3297 · (574) 372-7637
Phone(574) 372-7637
Organization SubpartYes
Authorized OfficialMegan MartinVice President · (574) 372-7638
Enumeration DateJune 19, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1437689783 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
1500 PROVIDENT DR STE A, Warsaw, IN 46580
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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 15D2038922

Medstat LLC · Warsaw, IN
Active · expires Mar 27, 2028
CLIA Number15D2038922
Laboratory TypePhysician Office
Certificate Effective DateMarch 28, 2026
Certificate Expiration DateMarch 27, 2028
Laboratory DirectorScott H. Ehmen
Laboratory Phone(574) 372-7637
Laboratory LocationMedstat LLC203 N Lake St, Warsaw, IN 46580
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANITA LYNN ALCORN FNP
Nurse Practitioner (Family)
1500 PROVIDENT DR STE A
WARSAW, IN 46580
Kosciusko County (574) 372-7637
LORI A YOUNG NP
Nurse Practitioner (Family)
1500 PROVIDENT DR STE A
WARSAW, IN 46580
Kosciusko County (574) 372-7637
CARMEN JOHNSTON PA
Physician Assistant
1500 PROVIDENT DR STE A
WARSAW, IN 46580
Kosciusko County (574) 372-7637
SCOTT HARLAN EHMEN MD
Family Medicine
1500 PROVIDENT DR STE A
WARSAW, IN 46580
Kosciusko County (574) 372-7637
JESSE R KOOISTRA FNP
Nurse Practitioner (Family)
1500 PROVIDENT DR STE A
WARSAW, IN 46580
Kosciusko County (574) 372-7637
AMIE L ROBERTS FNP-C
Nurse Practitioner (Family)
1500 PROVIDENT DR STE A
WARSAW, IN 46580
Kosciusko County (574) 372-7637

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 Medstat LLC's NPI number?

The NPI number for Medstat LLC is 1437689783. It was assigned to this organization in the NPPES registry on June 19, 2017.

Where is Medstat LLC located?

Medstat LLC is located at 1500 Provident Dr Ste A, Warsaw, IN 46580. The listed phone number is (574) 372-7637.

What is Medstat LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Medstat LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2038922) is associated with this NPI, valid through March 27, 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 Medstat LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.