Dekalb Memorial Hospital, Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

DEKALB MEMORIAL HOSPITAL, INC

Doing business as

DeKalb Health Medical Group

Practice address

1306 E 7TH St
Suite B
Auburn, IN 46706-2537

Phone

(260) 927-1982

Fax

(260) 927-8380

NPI assigned

May 22, 2015

Last updated

Sep 13, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Craig Polkow

Title

Ceo

Phone

(260) 925-4600

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• DeKalb Health Medical Group Doing business as

Locations

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473724800000",
    "number": "1871972869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 623",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467060623",
            "telephone_number": "260-927-8105",
            "fax_number": "260-333-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 E 7TH ST",
            "address_2": "SUITE B",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467062537",
            "telephone_number": "260-927-1982",
            "fax_number": "260-927-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-22",
        "last_updated": "2016-09-13",
        "status": "A",
        "authorized_official_last_name": "POLKOW",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-925-4600"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100104110N",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeKalb Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dekalb Memorial Hospital, Inc (Parkview Health Medical Group)
• Dekalb Memorial Hospital, Inc (Dekalb Health Medical Group-Putman)
• Dekalb Memorial Hospital, Inc
• Dekalb Memorial Hospital, Inc (Dekalb Health Medical Group)
• Dekalb Memorial Hospital, Inc (Parkview Dekalb Hospital)
• Dekalb Memorial Hospital, Inc (Parkview Dekalb Hospital)
• Dekalb Memorial Pharmacare LLC (DeKalb Health PharmaCare)
• Andrew Delagrange
• Michael B Delong, MD
• Gaesta E Denis

• General Practice Physician in Auburn, IN
• Providers in Auburn, IN by specialty
• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; 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.