Demotte Physicians Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DEMOTTE PHYSICIANS INC.

Practice address

520 8TH Ave NE
Demotte, IN 46310-9108

Phone

(219) 987-3581

Fax

(219) 987-7137

NPI assigned

Jun 19, 2006

Last updated

Nov 16, 2007By 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

Mr. David Vander Lugt, M.D.NPI 1265467476

Title

President

Phone

(219) 987-3581

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• David Vanderlugt, M.D.

  • Family Medicine Physician
  • Wheatfield, IN
  • NPI 1265467476
  NPD Authorized official

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195171200000",
    "number": "1396780573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20",
            "city": "DEMOTTE",
            "state": "IN",
            "postal_code": "463100020",
            "telephone_number": "219-987-3581",
            "fax_number": "219-987-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 8TH AVE NE",
            "city": "DEMOTTE",
            "state": "IN",
            "postal_code": "463109108",
            "telephone_number": "219-987-3581",
            "fax_number": "219-987-7137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEMOTTE PHYSICIANS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-11-16",
        "status": "A",
        "authorized_official_last_name": "VANDER LUGT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-987-3581",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200489280A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000000082478",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crestmark of Roselawn
• De Boer OD., LTD (De Boer Family Eyecare)
• Deboer OD LTD (DeBoer Family Eyecare)
• John Mark Deboer, O.D.
• Kevin John Defries, D.C.
• Gerrit H. Devries, O.D.
• Judy C Dewitt
• Carman Lashawn Dobbins
• Carly Dobin
• Dobson Chiropractic Center PC

• Family Medicine Physician in Demotte, IN
• Providers in Demotte, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.