Organization Active NPI

Daniel C Eby D.O. PC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Jasper, IN
National Provider Identifier
1205956646
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
02001643A Issued in IN
Legal business name
DANIEL C EBY D.O. PC
Practice address
600 W. 13TH St.
Suite 200
Jasper, IN 47546-1883
Phone
(812) 482-7441
Fax
(812) 482-7444
NPI assigned
Mar 30, 2007
Last updated
Jan 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Authorized official

Name
Dr. Daniel C Eby, D.O.NPI 1407859051
Title
President
Phone
(812) 482-7441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 02001643A IN Primary

Addresses

Primary practice location

600 W. 13TH St.
Suite 200
Jasper, IN 47546-1883

Mailing address

600 W. 13TH St.
Suite 200
Jasper, IN 47546-1883
Phone (812) 482-7441

Other identifiers 2

IdentifierTypeStateIssuer
000000332839OtherINANTHEM BLUE CROSS
200871340AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040928001075 IN Part B Supplier - Clinic/Group Practice 1557330305 Receives reassigned benefits from 6 practitioners
Practice locations: Jasper, IN
O20100930034946 IN DME Supplier - Physician - Orthopedic/Orthopedic Surgery 1557330305 Practice locations: Jasper, IN

National Provider Directory

National Provider Directory

Locations

600 W 13th St
Ste 200
Jasper, IN 47546
Phone (812) 482-7441

721 W 13th St
Ste 121
Jasper, IN 47546
Phone (812) 482-7441

Practitioners & affiliated clinicians

Practitioners 9

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": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1205956646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W. 13TH ST.",
            "address_2": "SUITE 200",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475461883",
            "telephone_number": "812-482-7441",
            "fax_number": "812-482-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W. 13TH ST.",
            "address_2": "SUITE 200",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475461883",
            "telephone_number": "812-482-7441",
            "fax_number": "812-482-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL C EBY D.O. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "EBY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-482-7441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IN",
            "license": "02001643A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000332839",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200871340A",
            "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 Jan 31, 2024; 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.