NPIMap

Organization Active NPI

Medical of Dubois a Professional Corporation

  • Urgent Care Clinic/Center
  • Jasper, IN
National Provider Identifier
1184719155
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
01025667 Issued in IN
Legal business name
MEDICAL OF DUBOIS A PROFESSIONAL CORPORATION
Practice address
695 3Rd Ave
Jasper, IN 47546-3602
Phone
(812) 634-6824
Fax
(812) 848-2277
NPI assigned
Oct 4, 2006
Last updated
May 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2016

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

Authorized official

Name
Thomas E Field, M.D.
Title
President
Phone
(812) 634-6824

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X 01025667 IN Primary
General Practice Physician 208D00000X 01025667 IN

Addresses

Primary practice location

695 3Rd Ave
Jasper, IN 47546-3602

Mailing address

695 3Rd Ave
Jasper, IN 47546-3602
Phone (812) 634-6824

Other identifiers 2

IdentifierTypeStateIssuer
DF6038OtherINMEDICARE RAILROAD
000000310221OtherINANTHEM

National Provider Directory

National Provider Directory

Locations

670 Rumbach Ave
Jasper, IN 47546
Phone (812) 634-6117

695 3rd Ave
Jasper, IN 47546
Phone (812) 634-6824

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464220800000",
    "number": "1184719155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 3RD AVE",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475463602",
            "telephone_number": "812-634-6824",
            "fax_number": "812-481-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 3RD AVE",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475463602",
            "telephone_number": "812-634-6824",
            "fax_number": "812-848-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL OF DUBOIS A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2016-05-26",
        "status": "A",
        "authorized_official_last_name": "FIELD",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-634-6824",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "IN",
            "license": "01025667",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01025667",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DF6038",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000310221",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.