Organization Active NPI

Dearborn County Surgery PC

  • Surgery Physician
  • Lawrenceburg, IN
National Provider Identifier
1073695243
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
DEARBORN COUNTY SURGERY PC
Practice address
368 Bielby Rd
Suite 100
Lawrenceburg, IN 47025-1099
Phone
(812) 537-5772
Fax
(812) 537-3936
NPI assigned
Oct 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Authorized official

Name
Beth A Kroger, ST, CMA
Title
Practice Manager
Phone
(812) 537-5772

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X IN Primary

Addresses

Primary practice location

368 Bielby Rd
Suite 100
Lawrenceburg, IN 47025-1099

Mailing address

368 Bielby Rd
Suite100
Lawrenceburg, IN 47025-2774
Phone (812) 537-5772

Other identifiers 2

IdentifierTypeStateIssuer
4401214MedicaidTN
100094180MedicaidIN

National Provider Directory

National Provider Directory

Locations

368 Bielby Rd
Ste 100
Lawrenceburg, IN 47025
Phone (812) 537-5772

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320883200000",
    "number": "1073695243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 BIELBY RD",
            "address_2": "SUITE100",
            "city": "LAWRENCEBURG",
            "state": "IN",
            "postal_code": "470252774",
            "telephone_number": "812-537-5772",
            "fax_number": "812-537-3936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 BIELBY RD",
            "address_2": "SUITE 100",
            "city": "LAWRENCEBURG",
            "state": "IN",
            "postal_code": "470251099",
            "telephone_number": "812-537-5772",
            "fax_number": "812-537-3936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEARBORN COUNTY SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2011-11-10",
        "status": "A",
        "authorized_official_last_name": "KROGER",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "812-537-5772",
        "authorized_official_credential": "ST, CMA"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4401214",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100094180",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceburg, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.