Directclinic SBC, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

DIRECTCLINIC SBC, LLC

Doing business as

DirectClinic

Practice address

1355 Getz Rd Ste C
Fort Wayne, IN 46804-1609

Phone

(260) 212-1900

NPI assigned

Feb 22, 2021

Last updated

Nov 30, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sudhakar Santhana Krishnan

Title

Ceo

Phone

(260) 750-0418

Specialties & licenses 1

Addresses

Other names 1

• DirectClinic Doing business as

Electronic endpoints 1

Tax ID family

Directclinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Directclinic SBC, LLC

  dba DirectClinic

  • Primary Care Clinic/Center
  • Kendallville, IN
  • NPI 1154086841
  NPD tax ID

Locations

Practitioners 1

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.

• Theodore Stephen Sauer Jr., M.D.

  • Family Medicine Physician
  • Kendallville, IN
  • NPI 1881674703
  NPD (past)

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638230400000",
    "number": "1336733229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 GETZ RD STE C",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041609",
            "telephone_number": "260-212-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 GETZ RD STE C",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041609",
            "telephone_number": "260-212-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECTCLINIC SBC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "SANTHANA KRISHNAN",
        "authorized_official_first_name": "SUDHAKAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-750-0418"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "FORTWAYNE",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1355 Getz Rd Ste C",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468041609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "DirectClinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DirectClinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michaela Dinwiddie
• Direct Imaging LLC
• Direct to You Hearing Care
• Directclinic LLC
• Directclinic LLC
• Cynthia Dirig, RN-BSN
• Levi Edward Lynn Dirig
• Melanie Dirig
• Brett Michael Disalle, DDS
• Kristine Louise Discala, PH.D, HSPP

• Primary Care Clinic/Center in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Primary Care Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.