Active NPI
Ernest Steve Dupre, MD
- Family Medicine Physician
- Sullivan, IN
National Provider Identifier
1992708192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01028949
- Practice address
- 2229 Mary Sherman Dr
Sullivan, IN 47882-7633 - Phone
- (812) 268-3318
- Fax
- (812) 268-4017
- NPI assigned
- May 23, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01028949 | IN | Primary |
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 01028949 | IN |
Addresses
Primary practice location
2229 Mary Sherman Dr
Sullivan, IN 47882-7633
Mailing address
2229 Mary Sherman Dr
Sullivan, IN 47882-7633
Phone (812) 268-3318
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100105420B | Medicaid | IN | |
| 200015680A | Medicaid | IN |
Other names 1
- Dr. Ernest Steve Dupre
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01028949 | IN | MD | Geriatric Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mso Clinics, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rural Health Clinic/Center
- Carlisle, IN
- NPI 1699194704
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199836800000",
"number": "1992708192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2229 MARY SHERMAN DR",
"city": "SULLIVAN",
"state": "IN",
"postal_code": "478827633",
"telephone_number": "812-268-3318",
"fax_number": "812-268-4017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2229 MARY SHERMAN DR",
"city": "SULLIVAN",
"state": "IN",
"postal_code": "478827633",
"telephone_number": "812-268-3318",
"fax_number": "812-268-4017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUPRE",
"first_name": "ERNEST",
"middle_name": "STEVE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-23",
"last_updated": "2008-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01028949",
"primary": true
},
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "IN",
"license": "01028949",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100105420B",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200015680A",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ERNEST",
"last_name": "DUPRE",
"middle_name": "STEVE",
"prefix": "DR.",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Sullivan, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.