Dekalb Memorial Hospital, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DEKALB MEMORIAL HOSPITAL, INC

Doing business as

Dekalb Health Medical Group-Butler

Practice address

409 E Washington St
Butler, IN 46721-1175

Phone

(260) 868-5843

Fax

(260) 868-5844

NPI assigned

Nov 13, 2006

Last updated

Jan 12, 2012By 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

Ms. Penny Lynn Griffin, CPC

Title

Billing Collection Manager

Phone

(260) 920-2794

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• DEKALB HEALTH MEDICAL GROUP-BUTLER Doing business as

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326326400000",
    "number": "1396816161",
    "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": "260-868-5843",
            "fax_number": "260-868-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 E WASHINGTON ST",
            "city": "BUTLER",
            "state": "IN",
            "postal_code": "467211175",
            "telephone_number": "260-868-5843",
            "fax_number": "260-868-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2012-01-12",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "PENNY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "BILLING COLLECTION MANAGER",
        "authorized_official_telephone_number": "260-920-2794",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2463909",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100104110B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC4531",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEKALB HEALTH MEDICAL GROUP-BUTLER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Butler, IN
• Providers in Butler, 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 Jan 12, 2012; 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.