Urology Associates of South Bend, PC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

UROLOGY ASSOCIATES OF SOUTH BEND, PC

Practice address

707 Cedar St
Suite #450
South Bend, IN 46617-2054

Phone

(574) 234-4100

Fax

(574) 282-1739

NPI assigned

Jul 14, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Arthur Phililp Depauw, M.D.

Title

President

Phone

(574) 234-4100

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063438117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 CEDAR ST",
            "address_2": "SUITE #450",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172054",
            "telephone_number": "574-234-4100",
            "fax_number": "574-282-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 CEDAR ST",
            "address_2": "SUITE #450",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172054",
            "telephone_number": "574-234-4100",
            "fax_number": "574-282-1739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY ASSOCIATES OF SOUTH BEND, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEPAUW",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "PHILILP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-234-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC SUPPLIER NUMBER",
            "identifier": "0323020001",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in South Bend, IN by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.