Individual provider Active NPI

Stephanie Depoy, DC

  • Chiropractor
  • Winamac, IN
National Provider Identifier
1295032035
Registry record updated Feb 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001839A Issued in IN
Practice address
116 E Pearl St
Winamac, IN 46996-1311
Phone
(574) 946-4113
Fax
(574) 946-4552
NPI assigned
Feb 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001839A IN Primary

Addresses

Primary practice location

116 E Pearl St
Winamac, IN 46996-1311

Mailing address

PO Box 250
Winamac, IN 46996-0250
Phone (574) 946-4113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110322000036 IN Practitioner - Chiropractic 2769665280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1998
Medicare assignment
May accept Medicare assignment
Group practices
Goble Heal Chiropractic PCGroup PAC ID 4789637497, 5 clinicians

Practice addresses (Care Compare)

800 Main St
Rochester, IN 46975-1543
Phone (574) 223-5557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08001839AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Goble Heal Chiropractic PC Chiropractor CurrentSince Feb 28, 2011 Accepting new patients

Locations

800 Main St
Rochester, IN 46975
Phone (574) 223-5557

116 E Pearl St
Winamac, IN 46996
Phone (574) 946-4113

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1295032035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "WINAMAC",
            "state": "IN",
            "postal_code": "469960250",
            "telephone_number": "574-946-4113",
            "fax_number": "574-946-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E PEARL ST",
            "city": "WINAMAC",
            "state": "IN",
            "postal_code": "469961311",
            "telephone_number": "574-946-4113",
            "fax_number": "574-946-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPOY",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-14",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001839A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winamac, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.