NPIMap

Organization Active NPI

Dekalb Health Memorial Hosptial Inc

Doing business as Dekalb Health Medical Group

  • Family Medicine Physician
  • Auburn, IN
National Provider Identifier
1891235800
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DEKALB HEALTH MEMORIAL HOSPTIAL INC
Doing business as
Dekalb Health Medical Group
Practice address
916 W. Seventh St.
Auburn, IN 46706-2013
Phone
(260) 920-2501
NPI assigned
Feb 24, 2017
Last updated
Feb 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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) 920-2501

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

916 W. Seventh St.
Auburn, IN 46706-2013

Mailing address

916 W. Seventh St.
Auburn, IN 46706-2013

Other names 1

  • Dekalb Health Medical Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487894400000",
    "number": "1891235800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 W. SEVENTH ST.",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467062013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 W. SEVENTH ST.",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467062013",
            "telephone_number": "260-920-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB HEALTH MEMORIAL HOSPTIAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-24",
        "last_updated": "2017-02-24",
        "status": "A",
        "authorized_official_last_name": "POLKOW",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-920-2501"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dekalb Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Auburn, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.