Dekalb Memorial Hospital, Inc

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

DEKALB MEMORIAL HOSPITAL, INC

Doing business as

DeKalb Health Medical Group

Practice address

208 Columbus St
Hicksville, OH 43526-1250

Phone

(419) 542-6692

NPI assigned

Apr 15, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Penny Lynn Griffin, CPC

Title

Credentialing

Phone

(260) 920-2794

Specialties & licenses 1

Addresses

Other names 1

• DeKalb Health Medical Group Doing business as

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1346669546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 623",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467060623",
            "telephone_number": "260-927-8105",
            "fax_number": "260-927-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 COLUMBUS ST",
            "city": "HICKSVILLE",
            "state": "OH",
            "postal_code": "435261250",
            "telephone_number": "419-542-6692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "PENNY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "260-920-2794",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeKalb Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chelsea Kelly DDS LLC
• Community Memorial Hospital
• Community Memorial Hospital
• Community Memorial Hospital
• Katlyn Nicole Craig
• Fort Wayne Cardiology Corporation
• Matt Walter Grant
• Matthew C Grothaus, M.D.
• Ashley Guilford, R.D.
• Johnathan Robert Haggerty, D.C.

• Otolaryngology Physician in Hicksville, OH
• Providers in Hicksville, OH by specialty
• Otolaryngology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.