NPIMap

Organization Active NPI

Dekalb Memorial Hospital, Inc

Doing business as Dekalb Health Medical Group

  • Family Medicine Physician
  • Auburn, IN
National Provider Identifier
1649240268
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DEKALB MEMORIAL HOSPITAL, INC
Doing business as
Dekalb Health Medical Group
Practice address
1314 E 7TH St
203
Auburn, IN 46706-2535
Phone
(260) 925-5511
Fax
(260) 925-8353
NPI assigned
Jan 25, 2006
Last updated
Nov 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Authorized official

Name
Ms. Penny Lynn Griffin
Title
Billing Collection Manager
Phone
(260) 920-2794

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1314 E 7TH St
203
Auburn, IN 46706-2535

Mailing address

PO Box 623
Auburn, IN 46706-0623
Phone (260) 925-5511

Other identifiers 3

IdentifierTypeStateIssuer
100104110AMedicaidIN
CC4531OtherINRAILROAD MEDICARE
2463909MedicaidOH

Other names 1

  • Dekalb Health Medical Group Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574035200000",
    "number": "1649240268",
    "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": "260-925-5511",
            "fax_number": "260-925-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 E 7TH ST",
            "address_2": "203",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467062535",
            "telephone_number": "260-925-5511",
            "fax_number": "260-925-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2019-11-18",
        "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."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100104110A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC4531",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2463909",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dekalb Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Auburn, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.