Larry G Payne, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12008602B Issued in IN

Practice address

605 S Wayne St
Waterloo, IN 46793-9472

Phone

(260) 837-2138

Fax

(260) 837-7810

NPI assigned

Jan 9, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Larry G Payne DDS LC

  • General Practice Dentistry
  • Waterloo, IN
  • NPI 1255884425
  NPD (past)
• Lindsey Daniher DMD, LLC

  • General Practice Dentistry
  • Waterloo, IN
  • NPI 1982363636
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1487703286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S WAYNE ST",
            "city": "WATERLOO",
            "state": "IN",
            "postal_code": "467939472",
            "telephone_number": "260-837-2138",
            "fax_number": "260-837-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S WAYNE ST",
            "city": "WATERLOO",
            "state": "IN",
            "postal_code": "467939472",
            "telephone_number": "260-837-2138",
            "fax_number": "260-837-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "LARRY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008602B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Diane Dunn
• Carly L Everingham
• Larry G Payne DDS LC
• Lindsey Daniher DMD, LLC
• Lee Joseph Nagel, D.C.
• Rooted in Wellness LLC
• Amanda J Talley
• Zachary Thiele, A.T.C.

• General Practice Dentistry in Waterloo, IN
• Providers in Waterloo, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.