Active NPI
Jeffrey L Payne, M.D.
- Family Medicine Physician
- Evansville, IN
National Provider Identifier
1144299322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01034143A
- Practice address
- 3844 1St Ave
Evansville, IN 47710-3326 - Phone
- (812) 428-6161
- Fax
- (812) 421-2883
- NPI assigned
- Mar 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01034143A | IN | Primary |
Addresses
Primary practice location
3844 1St Ave
Evansville, IN 47710-3326
Mailing address
PO Box 3407
Evansville, IN 47733-3407
Phone (812) 428-6161
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00251056 | Other | IN | RR MEDICARE |
| 200531110 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01034143A | IN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299628800000",
"number": "1144299322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3407",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477333407",
"telephone_number": "812-428-6161",
"fax_number": "812-421-2883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3844 1ST AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477103326",
"telephone_number": "812-428-6161",
"fax_number": "812-421-2883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYNE",
"first_name": "JEFFREY",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2011-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01034143A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00251056",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200531110",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.