Active NPI
Richard Deardurff, DC
- Chiropractor
- Lebanon, IN
National Provider Identifier
1750427217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 08001774
- Practice address
- 504 W Camp St
Lebanon, IN 46052-1647 - Phone
- (765) 482-7005
- Fax
- (765) 483-3021
- NPI assigned
- Jan 30, 2007
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 08001774 | IN | Primary |
Addresses
Primary practice location
504 W Camp St
Lebanon, IN 46052-1647
Mailing address
504 W Camp St
Lebanon, IN 46052-1647
Phone (765) 482-7005
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274832000000",
"number": "1750427217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 W CAMP ST",
"city": "LEBANON",
"state": "IN",
"postal_code": "460521647",
"telephone_number": "765-482-7005",
"fax_number": "765-483-3021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 W CAMP ST",
"city": "LEBANON",
"state": "IN",
"postal_code": "460521647",
"telephone_number": "765-482-7005",
"fax_number": "765-483-3021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEARDURFF",
"first_name": "RICHARD",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2010-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IN",
"license": "08001774",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.