NPIMap

Organization Active NPI

Flora Family Medicine, LLC

  • Family Medicine Physician
  • Flora, IN
National Provider Identifier
1629499330
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01056529A Issued in IN
Legal business name
FLORA FAMILY MEDICINE, LLC
Practice address
4 E Main St
Flora, IN 46929-1351
Phone
(574) 967-4523
Fax
(765) 446-5317
NPI assigned
Dec 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Authorized official

Name
Jason L Dutter, MD
Title
Physician
Phone
(765) 446-5417

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 01056529A IN Primary

Addresses

Primary practice location

4 E Main St
Flora, IN 46929-1351

Mailing address

PO Box 4699
Lafayette, IN 47903-4699
Phone (765) 449-2732

National Provider Directory

National Provider Directory

Locations

4 E Main St
Flora, IN 46929
Phone (574) 967-4523

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1387756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389657600000",
    "number": "1629499330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4699",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479034699",
            "telephone_number": "765-449-2732",
            "fax_number": "765-449-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 E MAIN ST",
            "city": "FLORA",
            "state": "IN",
            "postal_code": "469291351",
            "telephone_number": "574-967-4523",
            "fax_number": "765-446-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORA FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-23",
        "last_updated": "2014-01-14",
        "status": "A",
        "authorized_official_last_name": "DUTTER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "765-446-5417",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01056529A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flora, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.