Southeastern Indiana Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

01063413A Issued in IN

Legal business name

SOUTHEASTERN INDIANA DERMATOLOGY LLC

Practice address

955 N Michigan Ave
Ste 81
Greensburg, IN 47240-1487

Phone

(812) 212-8797

NPI assigned

May 3, 2011

Last updated

May 3, 2011By 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

Dr. Andrew Dubois, M.D.NPI 1518097237

Title

Owner

Phone

(812) 212-8797

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Andrew Michael Dubois, MD

  • Dermatology Physician
  • Batesville, IN
  • NPI 1518097237
  NPD Authorized official
• Lauren Nicole Gill, FNP-BC

  • Family Nurse Practitioner
  • Greensburg, IN
  • NPI 1942566021
  NPD (past)

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

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304380800000",
    "number": "1437441912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 N MICHIGAN AVE",
            "address_2": "STE 81",
            "city": "GREENSBURG",
            "state": "IN",
            "postal_code": "472401487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 N MICHIGAN AVE",
            "address_2": "STE 81",
            "city": "GREENSBURG",
            "state": "IN",
            "postal_code": "472401487",
            "telephone_number": "812-212-8797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN INDIANA DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-03",
        "last_updated": "2011-05-03",
        "status": "A",
        "authorized_official_last_name": "DUBOIS",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-212-8797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01063413A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Smillie, DNP, CRNA
• Alijah Smith
• Elaine Smith, BCABA
• Sheryl Sefton Soendlin
• Carrie A Somers, P.T.
• Jessica Lynn Sparks
• Tracy Springmeyer, PHARMD
• Angela D Stapp, M.S.,CCC-SLP
• Isaiah Steffen, MD
• Lily Steinhauer, DDS

• Dermatology Physician in Greensburg, IN
• Providers in Greensburg, IN by specialty
• Dermatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; 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.