NPIMap

Organization Active NPI

Redimed Dekalb LLC

  • General Practice Physician
  • Auburn, IN
National Provider Identifier
1669417457
Registry record updated Apr 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
REDIMED DEKALB LLC
Practice address
253 N Grandstaff Dr
Auburn, IN 46706-1668
Phone
(260) 925-9511
NPI assigned
Jun 17, 2006
Last updated
Apr 29, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2009

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

Authorized official

Name
Debbie T Brewer
Title
Director of Enrollment
Phone
(615) 465-7626

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

253 N Grandstaff Dr
Auburn, IN 46706-1668

Mailing address

253 N Grandstaff Dr
Auburn, IN 46706-1668
Phone (260) 925-9511

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1316 E 7th St
Ste D
Auburn, IN 46706

235 N Grandstaff Dr
Auburn, IN 46706
Phone (260) 925-9511

235 S Grandstaff Dr
#M
Auburn, IN 46706
Phone (219) 925-9511

253 N Grandstaff Dr
Auburn, IN 46706
Phone (260) 925-9511

Practitioners & affiliated clinicians

Practitioners 100

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.

View all 100

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240963200000",
    "number": "1669417457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 N GRANDSTAFF DR",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467061668",
            "telephone_number": "260-925-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 N GRANDSTAFF DR",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467061668",
            "telephone_number": "260-925-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDIMED DEKALB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2009-04-29",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR OF ENROLLMENT",
        "authorized_official_telephone_number": "615-465-7626"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 29, 2009; 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.