Active NPI
Ashley Jo Deardurff, CST
- Surgical Technologist
- Lafayette, IN
National Provider Identifier
1831409424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- CERT # 110845
- Practice address
- 2600 Greenbush St
Lafayette, IN 47904-2477 - Phone
- (765) 448-8000
- NPI assigned
- Oct 15, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | CERT # 110845 | IN | Primary |
Addresses
Primary practice location
2600 Greenbush St
Lafayette, IN 47904-2477
Mailing address
PO Box 5545
Lafayette, IN 47903-5545
Phone (765) 448-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000682001 | Other | IN | ANTHEM PROVIDER NUMBER |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CERT # 110845 | IN | MD | Surgical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290211200000",
"number": "1831409424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5545",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479035545",
"telephone_number": "765-448-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 GREENBUSH ST",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479042477",
"telephone_number": "765-448-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEARDURFF",
"first_name": "ASHLEY",
"middle_name": "JO",
"credential": "CST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-15",
"last_updated": "2010-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "IN",
"license": "CERT # 110845",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER NUMBER",
"identifier": "000000682001",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.