Individual provider Active NPI

Jeffrey A. Justus, D.O.

  • Emergency Medicine Physician
  • North Vernon, IN
National Provider Identifier
1811023864
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
02000790 Issued in IN
Practice address
301 Henry St
North Vernon, IN 47265-1030
Phone
(812) 352-4200
NPI assigned
Feb 26, 2007
Last updated
Jan 7, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 02000790 IN Primary

Addresses

Primary practice location

301 Henry St
North Vernon, IN 47265-1030

Mailing address

1700 South B St.
Richmond, IN 47374
Phone (765) 969-3510

Other identifiers 1

IdentifierTypeStateIssuer
100373310MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070730000111 IN Practitioner - Emergency Medicine 4981705332 Reassigns benefits to 1 organization
I20230914002938 IL Practitioner - Emergency Medicine 4981705332 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02000790INMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince May 1, 2023 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince May 1, 2023 Accepting new patients
Integritas Emergency Physician Services, LLC Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Major Hospital Past Accepting new patients
River Crossing Emergency Physicians Emergency Medicine Past Accepting new patients
Rush Memorial Hospital Past Accepting new patients
St. Vincent Health Wellness and Preventive Care Institute, Inc. Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2250 N Illinois Ave
Carbondale, IL 62901
Phone (618) 833-1691

301 Henry St
North Vernon, IN 47265
Phone (812) 352-4200

1300 N Main St
Rushville, IN 46173
Phone (317) 802-3106

911 N Shelby St
Salem, IN 47167
Phone (812) 883-5881

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

3901 S 7th St
Terre Haute, IN 47802
Phone (812) 232-0021

473 SE Greenville Ave
Winchester, IN 47394
Phone (765) 584-0004

Organizations & group practices 8

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1811023864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SOUTH B ST.",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "47374",
            "telephone_number": "765-969-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HENRY ST",
            "city": "NORTH VERNON",
            "state": "IN",
            "postal_code": "472651030",
            "telephone_number": "812-352-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTUS",
        "first_name": "JEFFREY",
        "middle_name": "A.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02000790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100373310",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Vernon, IN

Sources for this page

Verify at the official NPI Registry.