DIRECTCLINIC SBC LLC NPI 1154086841

NPI Information

  • NPI: 1154086841
  • Provider Name: DIRECTCLINIC SBC, LLC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: DIRECTCLINIC
  • CLIA Number: 15D2244535
  • Address: 300 W OHIO ST
    KENDALLVILLE, IN
    ZIP 46755
  • Phone: (260) 212-1906

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NPI Details

DIRECTCLINIC SBC, LLC is a primary care clinic center in Kendallville, IN. DIRECTCLINIC SBC, LLC NPI is 1154086841. The provider is registered as an organization entity type.
The provider Is Doing Business As Directclinic.

The provider's business location address is:

300 W OHIO ST
KENDALLVILLE, IN
ZIP 46755-018
Phone: (260) 212-1906

The provider's authorized official is Sudhakar Santhana Krishnan .
The authorized official title is Ceo and has the following contact phone number (260) 750-0418.

The CLIA number assigned to this NPI record is 15D2244535 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/8/2021 and was last updated on 11/30/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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