PREMISE HEALTH OF INDIANA MEDICAL PC
NPI 1477226454
Clinic/Center - Multi-Specialty in Shipshewana, IN
About Premise Health Of Indiana Medical Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PREMISE HEALTH OF INDIANA MEDICAL PC (NPI 1477226454), doing business as Midway Lakepark - Shipshewana, is a healthcare organization registered as a multi-specialty in Shipshewana, Indiana and active in the NPI registry since July 2021. The organization holds a CLIA Waiver certificate valid through October 21, 2026 and lists Edward William Schwartz, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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 15D1090923
Premise Health Of Indiana Medical, PC · Shipshewana, INFrequently 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 Premise Health Of Indiana Medical PC's NPI number?
The NPI number for Premise Health Of Indiana Medical PC is 1477226454. It was assigned to this organization in the NPPES registry on July 27, 2021. The provider is doing business as Midway Lakepark - Shipshewana.
Where is Premise Health Of Indiana Medical PC located?
Premise Health Of Indiana Medical PC is located at 750 E Middlebury St, Shipshewana, IN 46565. The listed phone number is (260) 768-7411.
What is Premise Health Of Indiana Medical PC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Does Premise Health Of Indiana Medical PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 15D1090923) is associated with this NPI, valid through October 21, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Premise Health Of Indiana Medical PC was last updated on February 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.
# Premise Health Of Indiana Medical Pc · NPI 1477226454
Multi-Specialty organization in Shipshewana, Indiana. Organization record, active in the CMS NPPES registry since July 27, 2021.
## Identity
- **NPI:** 1477226454 (Entity type: Organization)
- **Enumerated:** July 27, 2021
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Also known as:** Midway Lakepark - Shipshewana (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Edward Schwartz, PRESIDENT
## Practice location
- **Address:** 750 E MIDDLEBURY ST, Shipshewana, IN 46565-8801
- **Phone:** (260) 768-7411
## Record status
- **NPPES last updated:** February 11, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1477226454) · Data from the CMS NPPES public registry.