Active NPI
Henry W. Deleeuw, M.D.
- Orthopaedic Surgery of the Spine Physician
- South Bend, IN
National Provider Identifier
1710969712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery of the Spine Physician
- License
- 01038307A
- Practice address
- 53880 Carmichael Dr
South Bend, IN 46635-1567 - Phone
- (574) 247-9441
- Fax
- (574) 247-9442
- NPI assigned
- Nov 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery of the Spine Physician | 207XS0117X | 01038307A | IN | Primary |
Addresses
Primary practice location
53880 Carmichael Dr
South Bend, IN 46635-1567
Mailing address
53880 Carmichael Dr
South Bend, IN 46635-1567
Phone (574) 247-9441
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
| License | State | Type | Specialty |
|---|---|---|---|
| 01038307A | IN | MD | Orthopaedic Surgery of the Spine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194220800000",
"number": "1710969712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53880 CARMICHAEL DR",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351567",
"telephone_number": "574-247-9441",
"fax_number": "574-247-9442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53880 CARMICHAEL DR",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351567",
"telephone_number": "574-247-9441",
"fax_number": "574-247-9442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELEEUW",
"first_name": "HENRY",
"middle_name": "W.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-16",
"last_updated": "2007-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0117X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
"state": "IN",
"license": "01038307A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.