Tri-State Colorectal Group, LLC

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

Legal business name

TRI-STATE COLORECTAL GROUP, LLC

Practice address

950 S Kenmore Dr Ste B
Evansville, IN 47714-7513

Phone

(812) 301-8110

Fax

(812) 401-4001

NPI assigned

Aug 15, 2017

Organization subpart

No

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

Authorized official

Name

Deane L Smith IINPI 1255339180

Title

Partner

Phone

(812) 301-8110

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 6

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

• Deane L Smith II, MD

  • Colon & Rectal Surgery Physician
  • Newburgh, IN
  • NPI 1255339180
  Medicare reassignment NPD Authorized official
• Joseph Christopher Adongay, M.D.

  • Colon & Rectal Surgery Physician
  • Evansville, IN
  • NPI 1144519430
  Medicare reassignment NPD
• Santiago Arruffat, M.D.

  • Colon & Rectal Surgery Physician
  • Evansville, IN
  • NPI 1730132440
  Medicare reassignment NPD
• Heather Bennett Matheson, MD

  • Colon & Rectal Surgery Physician
  • Evansville, IN
  • NPI 1275858839
  Medicare reassignment NPD
• Samantha Elaine Shoultz, NP

  • Nurse Practitioner
  • Newburgh, IN
  • NPI 1225400070
  Medicare reassignment NPD
• Ashleigh Robertson, NP

  • Nurse Practitioner
  • Evansville, IN
  • NPI 1811632920
  NPD

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1083130751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 S KENMORE DR STE B",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477147513",
            "telephone_number": "812-301-8110",
            "fax_number": "812-401-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 S KENMORE DR STE B",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477147513",
            "telephone_number": "812-301-8110",
            "fax_number": "812-401-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE COLORECTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-15",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DEANE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "812-301-8110",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tri State Internal Medicine Source
• Tri State RX, LLC
• Tri State Transportation
• Tri-State Anesthesiologists, PC
• Tri-State Arthritis & Rheumatology Center, LLC
• Tri-State Dermatology & Skin Care, LLC
• Tri-State Ear, Nose, and Throat Surgeons, Inc.
• Tri-State Hearing Healthcare, LLC
• Tri-State Neurosurgical Inc
• Tri-State Ophthalmology Consultants PMC

• Colon & Rectal Surgery Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Colon & Rectal Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.