Individual provider Active NPI

Duane Charles Flannagan, M.D.

  • Ophthalmology Physician
  • Jasper, IN
National Provider Identifier
1710957170
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
01026234 Issued in IN
Practice address
200 Saint Charles St
Jasper, IN 47546-9053
Phone
(812) 482-6424
Fax
(812) 634-9701
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 01026234 IN Primary

Addresses

Primary practice location

200 Saint Charles St
Jasper, IN 47546-9053

Mailing address

200 Saint Charles St
Jasper, IN 47546-9053
Phone (812) 482-6424

Other identifiers 3

IdentifierTypeStateIssuer
P00097857OtherINRAILROAD MEDICARE
000000335549OtherINANTHEM
10010925MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01026234INMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vitreo Retinal Center PC Ophthalmology Past Accepting new patients
Southern Indiana Eye Associates LLC Ophthalmology PastSince Jul 1, 2017 Accepting new patients
Ophthalmology Associates, PSC Ophthalmology Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1710957170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SAINT CHARLES ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475469053",
            "telephone_number": "812-482-6424",
            "fax_number": "812-634-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SAINT CHARLES ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475469053",
            "telephone_number": "812-482-6424",
            "fax_number": "812-634-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANNAGAN",
        "first_name": "DUANE",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01026234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00097857",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000335549",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10010925",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2018; 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.