RDM SURGICAL ASSISTANT (NPI# 1265054712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265054712 |
| Entity Type | Organization |
| Organization Name | RDM SURGICAL ASSISTANT |
| Practice Address |
10081 Fredericksburg Rd Nw Depauw IN 47115-8629 |
| Practice Telephone | 8122676695 |
| Mailing Telephone | 8122676695 |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2020-06-04 |
| Authorized Official Name | REBECCA LOU AUTRY (OWNER) |
| Authorized Official Telephone | 8122676695 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| RLC SURGICAL ASSIST, PA-C, CSA | Doing Business As Name - Organization |
| Street Address |
10081 FREDERICKSBURG RD NW |
| City | DEPAUW |
| State | IN |
| Zip Code | 47115-8629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427364926 | Rebecca Lou Autry | Physician Assistant | 10081 Fredericksburg Rd Nw, Depauw, IN 47115-8629 | 2010-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902076391 | Joseph R Kost | Dentist | 13665 Blue River Dr Nw, Depauw, IN 47115 | 2008-03-03 |
| 1164647343 | Susan H Christie | Occupational Therapist | 1800 Kennedy Mott Rd Nw, Depauw, IN 47115-8017 | 2007-04-14 |
| 1912413378 | Rowland D. Wetzel | Durable Medical Equipment & Medical Supplies | 2760 Kennedy Mott Rd Nw, Depauw, IN 47115-8026 | 2017-12-21 |
| 1225544513 | Rxpress Mobility LLC | Durable Medical Equipment & Medical Supplies | 2760 Kennedy Mott Rd Nw, Depauw, IN 47115-8026 | 2017-12-21 |
| 1063728772 | Mary Alice Childers | Massage Therapist | 4040 Loudens Chapel Rd Nw, Depauw, IN 47115-8745 | 2010-08-19 |
| 1386088672 | William Walter Holt | Internal Medicine | 10002 Mudd Ln Nw, Depauw, IN 47115-9173 | 2013-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912413378 | Rowland D. Wetzel | Durable Medical Equipment & Medical Supplies | 2760 Kennedy Mott Rd Nw, Depauw, IN 47115-8026 | 2017-12-21 |
| 1386088672 | William Walter Holt | Internal Medicine | 10002 Mudd Ln Nw, Depauw, IN 47115-9173 | 2013-04-17 |
| 1063728772 | Mary Alice Childers | Massage Therapist | 4040 Loudens Chapel Rd Nw, Depauw, IN 47115-8745 | 2010-08-19 |
| 1902076391 | Joseph R Kost | Dentist | 13665 Blue River Dr Nw, Depauw, IN 47115 | 2008-03-03 |
| 1164647343 | Susan H Christie | Occupational Therapist | 1800 Kennedy Mott Rd Nw, Depauw, IN 47115-8017 | 2007-04-14 |
| 1225544513 | Rxpress Mobility LLC | Durable Medical Equipment & Medical Supplies | 2760 Kennedy Mott Rd Nw, Depauw, IN 47115-8026 | 2017-12-21 |
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427364926 | Rebecca Lou Autry | Physician Assistant | 10081 Fredericksburg Rd Nw, Depauw, IN 47115-8629 | 2010-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386289957 | Jordan Nickley Nemer | Physician Assistant | 270 E Day Rd Ste 200, Mishawaka, IN 46545-3444 | 2019-11-07 |
| 1760947329 | Ellen M Randall | Physician Assistant | 705 Riley Hospital Dr Ste 2514, Indianapolis, IN 46202-5109 | 2019-02-07 |
| 1710459839 | Alyssa Tripp | Physician Assistant | 1007 Lincolnway Rm 1107, La Porte, IN 46350-3201 | 2018-12-31 |
| 1992283899 | Kelsey Arnold | Physician Assistant | 275 W Bassett Rd Ste 2, Shelbyville, IN 46176-8575 | 2018-08-02 |
| 1396249926 | Deaconess Specialty Physicians, Inc | Physician Assistant | 1813 Willow St Ste 5a, Vincennes, IN 47591-4279 | 2018-03-20 |
| 1477924892 | Kristen Marie Ness | Physician Assistant | 13100 E 136th St Ste 2000, Fishers, IN 46037-9440 | 2015-10-12 |
| 1982945960 | Heather Bunnell | Physician Assistant | 3943 Hay Market Dr, Jeffersonville, IN 47130-8260 | 2013-03-15 |
| 1255685772 | Jarron J Lincoln | Physician Assistant | 5230 E Stop 11 Rd Ste 250, Indianapolis, IN 46237 | 2012-11-06 |
| 1558685495 | Douglas D Kesler | Physician Assistant | 1411 S Creasy Lane, Suite 120, Lafayette, IN 47905-7433 | 2010-03-22 |
| 1720214208 | Felipe Isip Chua Jr. | Physician Assistant | 101 West 61st Avenue, Hobart, IN 46342 | 2009-06-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.