DR. NICHOLAS DEFAUW (NPI# 1578791398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578791398 |
| Entity Type | Individual |
| Full Name | DR. NICHOLAS DEFAUW |
| Credential | DO |
| Practice Address |
1824 Dorchester Ct Ste A Goshen IN 46526 |
| Mailing Address |
1824 Dorchester Ct Ste A Goshen IN 46526-6819 |
| Practice Telephone | 5745342548 |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2019-08-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 5101018485 | MI | Allopathic & Osteopathic Physicians |
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
02005770A | IN | Allopathic & Osteopathic Physicians |
| N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
64907-21 | WI | Allopathic & Osteopathic Physicians |
| N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
5101018485 | MI | Allopathic & Osteopathic Physicians |
| N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
P6963 | TX | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 849 Kellogg Ave, Janesville, WI 535462808 | 6087557960 | 6087557873 |
| Street Address |
1824 DORCHESTER CT STE A |
| City | GOSHEN |
| State | IN |
| Zip Code | 46526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497911325 | Christopher John Owens | Orthopaedic Surgery | 1824 Dorchester Ct Ste A, Goshen, IN 46526-6819 | 2008-07-30 |
| 1124590237 | Maritza E Chavez Stahly | Specialist/Technologist | 1824 Dorchester Ct Ste A, Goshen, IN 46526-6819 | 2018-12-31 |
| 1477087575 | Kirby Wilcoxson | Nurse Practitioner | 1824 Dorchester Ct Ste A, Goshen, IN 46526-6819 | 2017-04-14 |
| 1780096156 | Robert Lane Jr. | Orthopaedic Surgery | 1824 Dorchester Ct Ste A, Goshen, IN 46526-6819 | 2014-05-20 |
| 1487094371 | Lindsay M Neff | Registered Nurse | 1824 Dorchester Ct Ste A, Goshen, IN 46526 | 2013-06-25 |
| 1376836916 | Kevin Michael Houseman | Podiatrist | 1824 Dorchester Ct Ste A, Goshen, IN 46526 | 2011-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134631344 | Heidi Kauffmann | Social Worker | 2606 Peddler's Village Rd. Suite 210, Goshen, IN 46526 | 2017-10-27 |
| 1952812034 | Blue Diamond Villas | Skilled Nursing Facility | 1510 Sandpiper Lane, Goshen, IN 46526 | 2017-10-17 |
| 1578086534 | Anthony Escotto | Physical Therapist | 223 North Chicago Avenue, Goshen, IN 46526 | 2017-07-21 |
| 1831544774 | April Noelle Hart | Registered Nurse | 2606 Peddlers Village Rd., Suite 215, Goshen, IN 46526 | 2016-04-28 |
| 1639530108 | Amanda Miller | Physical Therapy Assistant | 114 Watertower Court, Goshen, IN 46526 | 2016-03-11 |
| 1720486095 | Gloria White | Pharmacist | 4430 Elkhart Road, C/o Walgreens, Goshen, IN 46526 | 2014-12-18 |
| 1184982472 | Dianna Christine Hoover | Occupational Therapist | 1627 Autumn Blaze Lane, Goshen, IN 46526 | 2012-04-24 |
| 1629361357 | Amy Rebecca Pointon | Nurse Practitioner | 1615 Winsted Dr Ste 1, Goshen, IN 46526 | 2011-05-27 |
| 1659670685 | Michiana Eye Center LLC | Optometrist | 1747 Stafford Ct, Goshen, IN 46526 | 2011-03-16 |
| 1467759001 | Natasha Candace Pontius | Occupational Therapy Assistant | 2400 College Aveune, Goshen, IN 46526 | 2011-02-17 |
| Find all providers in zip 46526 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962061135 | Central Indiana Orthopedics, PC | Family Medicine | 14300 E 138th Bldg B, Fishers, IN 46037-0087 | 2019-06-11 |
| 1104326909 | Orthopaedic Associates, Inc. | Family Medicine | 4011 Gateway Blvd Ste 100, Newburgh, IN 47630-8947 | 2018-02-19 |
| 1700231313 | Heather Saffel | Family Medicine | 111 W Jefferson Blvd Ste 100, South Bend, IN 46601-1993 | 2016-05-02 |
| 1922477686 | Orthopaedic Associates, Inc. | Family Medicine | 5828 Pearl Dr, Evansville, IN 47712-8116 | 2015-09-23 |
| 1295137925 | Ball State University | Family Medicine | Hp 260, Muncie, IN 47306-0001 | 2014-09-25 |
| 1992118822 | Zachary Conner Ritchie | Family Medicine | 301 Satori Pkwy Ste 120, Avon, IN 46123-6407 | 2014-06-09 |
| 1740692078 | Joel Jaeger | Family Medicine | 275 W Bassett Rd Ste 3, Shelbyville, IN 46176-8575 | 2014-05-21 |
| 1457652992 | Martha Ann Taylor | Family Medicine | 105 Hendron Hills Dr, Vincennes, IN 47591-3638 | 2010-11-16 |
| 1649598707 | Rajih Y Haddawi | Family Medicine | 2631 S Atlee St, Bloomington, IN 47401-4536 | 2010-05-12 |
| 1538300561 | Michael Robert Messmer | Family Medicine | 3221 Beacon Parkway, Granger, IN 46530 | 2009-03-21 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. NICHOLAS DEFAUW.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.