DTRC, LLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

01036126A Issued in IN

Legal business name

DTRC, LLC

Practice address

6447 S East St
Suite C
Indianapolis, IN 46227-2118

Phone

(317) 807-0247

Fax

(317) 735-1951

NPI assigned

Apr 11, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey Neal Dewester, M.D.NPI 1649244450

Title

Owner / Physician

Phone

(317) 807-0247

Specialties & licenses 1

Addresses

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.

• Jeffrey Neal Dewester, M.D.

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1649244450
  Authorized official Same address or phone

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

{
    "created_epoch": "1397174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397174400000",
    "number": "1568881076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6447 S EAST ST",
            "address_2": "SUITE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272118",
            "telephone_number": "317-807-0247",
            "fax_number": "317-735-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6447 S EAST ST",
            "address_2": "SUITE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272118",
            "telephone_number": "317-807-0247",
            "fax_number": "317-735-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DTRC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-11",
        "last_updated": "2014-04-11",
        "status": "A",
        "authorized_official_last_name": "DEWESTER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "NEAL",
        "authorized_official_title_or_position": "OWNER / PHYSICIAN",
        "authorized_official_telephone_number": "317-807-0247",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IN",
            "license": "01036126A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Adult Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; 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.