# MEDSTAT LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942388368
- **Authorized official:** KRISTINA MUSIC (DIRECTOR OF PROVIDER ENROLLMENT)
- **Authorized official phone:** (877) 892-9815

## Contact information

- **Practice address:** 1500 PROVIDENT DR, SUITE A, WARSAW, IN 46580-3291
- **Practice address phone:** (574) 372-7637
- **Practice address fax:** (574) 372-7655
- **Mailing address:** 1500 PROVIDENT DR, SUITE A, WARSAW, IN 46580-3291
- **Mailing address phone:** (574) 372-7637
- **Mailing address fax:** (574) 372-7655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | — |
| 207RH0003X | Hematology & Oncology Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 2083X0100X | Occupational Medicine Physician | — | NULL | — |
| 2083X0100X | Occupational Medicine Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208C00000X | Colon & Rectal Surgery Physician | — | NULL | — |
| 208C00000X | Colon & Rectal Surgery Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 11/02/2006
- **Last updated:** 07/09/2025