Active NPI
Brandt L Dodson, DPM
- Podiatrist
- Newburgh, IN
National Provider Identifier
1891861035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 07000675A
- Practice address
- 4233 Gateway Blvd
Newburgh, IN 47630-8900 - Phone
- (812) 858-5786
- Fax
- (812) 490-4512
- NPI assigned
- Nov 28, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 07000675A | IN | Primary |
Addresses
Primary practice location
4233 Gateway Blvd
Newburgh, IN 47630-8900
Mailing address
PO Box 3868
Evansville, IN 47737-3868
Phone (812) 858-5786
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100248490 | Medicaid | IN | |
| 000000109422 | Other | IN | ANTHEM |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357171200000",
"number": "1891861035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3868",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477373868",
"telephone_number": "812-858-5786",
"fax_number": "812-490-4512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4233 GATEWAY BLVD",
"city": "NEWBURGH",
"state": "IN",
"postal_code": "476308900",
"telephone_number": "812-858-5786",
"fax_number": "812-490-4512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DODSON",
"first_name": "BRANDT",
"middle_name": "L",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2013-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "IN",
"license": "07000675A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100248490",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000109422",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newburgh, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.