NPIMap

Organization Active NPI

Dekalb Memorial Hospital, Inc

Doing business as Dekalb Health Medical Group-Family Practice Associates

  • Family Medicine Physician
  • Auburn, IN
National Provider Identifier
1366722415
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DEKALB MEMORIAL HOSPITAL, INC
Doing business as
Dekalb Health Medical Group-Family Practice Associates
Practice address
1314 E 7TH St
Suite 101
Auburn, IN 46706-2535
Phone
(260) 925-0403
Fax
(260) 925-9545
NPI assigned
Aug 22, 2011
Last updated
Sep 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Authorized official

Name
Craig Polkow
Title
Ceo
Phone
(260) 925-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1314 E 7TH St
Suite 101
Auburn, IN 46706-2535

Mailing address

PO Box 623
Auburn, IN 46706-0623
Phone (260) 920-2794

Other names 1

  • DEKALB HEALTH MEDICAL GROUP-FAMILY PRACTICE ASSOCIATES Doing business as

National Provider Directory

National Provider Directory

Locations

1061 Smaltz Way
Auburn, IN 46706
Phone (260) 255-3665

1306 E 7th St
Ste D
Auburn, IN 46706
Phone (260) 927-0035

1310 E 7th St
Ste C
Auburn, IN 46706
Phone (260) 920-2000

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473724800000",
    "number": "1366722415",
    "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": "260-920-2794",
            "fax_number": "260-927-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 E 7TH ST",
            "address_2": "SUITE 101",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467062535",
            "telephone_number": "260-925-0403",
            "fax_number": "260-925-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-22",
        "last_updated": "2016-09-13",
        "status": "A",
        "authorized_official_last_name": "POLKOW",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-925-4600"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEKALB HEALTH MEDICAL GROUP-FAMILY PRACTICE ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Auburn, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.