Ann D Declue, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35.120757 Issued in OH

Practice address

990 Belvedere Dr Ste a
Lebanon, OH 45036-2890

Phone

(240) 313-9850

Fax

(240) 313-9851

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1790879633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 BELVEDERE DR STE A",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450362890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 BELVEDERE DR STE A",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450362890",
            "telephone_number": "240-313-9850",
            "fax_number": "240-313-9851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECLUE",
        "first_name": "ANN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36073550",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.120757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0086602",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia Davis, OTR/L
• Lia R Davis, RN
• Sara Ruth Davis, RN
• Shauna Day
• Gabrielle Lynn Decaestecker, PA
• Tony Dejtiranukul, D.C.
• Wendy Delarosa
• Grace Clair Delcamp
• Delhi Dental Assoc. JS Baxter DDS Inc
• Delta EMS LLC

• Internal Medicine Physician in Lebanon, OH
• Providers in Lebanon, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; 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.