DOUGLAS C DEDELOW (NPI# 1861492993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861492993 |
| Entity Type | Individual |
| Full Name | DOUGLAS C DEDELOW |
| Credential | DO |
| Practice Address |
1400 S Lake Park Ave Ste 205 Hobart IN 46342-6790 |
| Mailing Address |
9660 Wicker Avenue St John IN 46373-9487 |
| Practice Telephone | 2199428620 |
| Practice Fax Number | 2199426356 |
| Mailing Telephone | 2192262203 |
| Mailing Fax Number | 2192262202 |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2010-07-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 02001822A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200127880 | 05 | |
| IN | MEDICARE PTAN | 256700A | 01 |
| Street Address |
1400 S LAKE PARK AVE STE 205 |
| City | HOBART |
| State | IN |
| Zip Code | 46342-6790 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780689984 | Paul J Stanish | Surgery | 1400 S Lake Park Ave, Ste 200, Hobart, IN 46342-6791 | 2005-06-15 |
| 1144734849 | Kristen Nicole Mcging | Nurse Practitioner | 1400 S Lake Park Ave, Hobart, IN 46342-6790 | 2017-11-17 |
| 1003350067 | Tina Crum | Advanced Practice Midwife | 1400 S Lake Park Ave, Hobart, IN 46342-6790 | 2016-12-11 |
| 1609318922 | Megan Doheny | Nurse Practitioner | 1400 S Lake Park Ave, Suite 205, Hobart, IN 46342-6790 | 2016-11-17 |
| 1497103352 | Jennifer R Corsbie | Physician Assistant | 1400 S Lake Park Ave, Suite 200, Hobart, IN 46342-6790 | 2016-06-01 |
| 1144699927 | Kathy Nobles Fnp-c | Clinic/Center | 1400 S Lake Park Ave, Suite 405, Hobart, IN 46342-6790 | 2015-09-22 |
| 1467857136 | Jennifer Lynn Klaich | Nurse Practitioner | 1400 S Lake Park Ave, Suite 300, Hobart, IN 46342-6790 | 2014-10-23 |
| 1104252246 | Community Care Network, Inc | Urology | 1400 S Lake Park Ave, Suite 105, Hobart, IN 46342-6790 | 2013-09-20 |
| 1265752927 | David G. Gross, D.o., P.C. | Optometrist | 1400 S Lake Park Ave, Suite 103, Hobart, IN 46342-6790 | 2010-06-04 |
| 1932427523 | St Mary Medical Center Inc | Obstetrics & Gynecology | 1400 S Lake Park Ave, Ste 205, Hobart, IN 46342-6790 | 2010-05-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952734295 | Carleen Kaucky | Nurse Practitioner | 1445 South Lake Park Ave, Hobart, IN 46342 | 2013-08-09 |
| 1679827133 | Fresenius Medical Care Nw Indiana, LLC | Clinic/Center | 1330 W. Wisconsin St., Hobart, IN 46342 | 2012-11-06 |
| 1356600548 | Accurate Home Health Inc | Home Health | 8792 E. Ridge Road, Suite A, Hobart, IN 46342 | 2012-05-09 |
| 1164728051 | Lynn Rentz | Mechanotherapist | 103 E.third St., Suite 1, Hobart, IN 46342 | 2011-02-10 |
| 1720214208 | Felipe Isip Chua Jr. | Physician Assistant | 101 West 61st Avenue, Hobart, IN 46342 | 2009-06-10 |
| 1326289067 | Sheila Anne Flynn | Registered Nurse | 101 W. 61st Ave., Hobart, IN 46342 | 2009-03-10 |
| 1194941021 | Arc Bridges, Inc | Custodial Care Facility | 3583 Randolph Drive, Hobart, IN 46342 | 2007-04-18 |
| 1164542940 | Felix Rosel Gozo Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1354 S Lake Park Avenue, St Marys Spectrum Rehab Center Cardiac, Hobart, IN 46342 | 2007-03-29 |
| 1003932666 | Major Hospital | Skilled Nursing Facility | 4410 W 49th Ave, Hobart, IN 46342 | 2007-03-22 |
| 1295884682 | Marie Jean Mercado Hedges | Physical Therapist | 4530 16th St., Hobart, IN 46342 | 2007-01-09 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346567401 | Munster Medical Research Foundation Inc | Obstetrics & Gynecology | 1400 S Lake Park Avenue, Ste 205, Hobart, IN 46342-6790 | 2010-04-29 |
| 1831267715 | The Woman's Wellness Center, P.C. | Obstetrics & Gynecology | 1600 S. Lake Park Ave., Suite 1103, Hobart, IN 46342-6638 | 2006-12-01 |
| 1447609870 | Lachanda Leann Dunlap-wright | Obstetrics & Gynecology | 1400 S Lake Park Ave Ste 205, Hobart, IN 46342-6791 | 2016-06-07 |
| 1932427523 | St Mary Medical Center Inc | Obstetrics & Gynecology | 1400 S Lake Park Ave, Ste 205, Hobart, IN 46342-6790 | 2010-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740815885 | Candice Marie Miles | Obstetrics & Gynecology | 365 Conestoga Dr, Chesterton, IN 46304-1559 | 2020-03-09 |
| 1861034688 | Heart City Health Center, Inc. | Obstetrics & Gynecology | 1545 Cassopolis Street, Elkhart, IN 46514 | 2019-10-14 |
| 1417458225 | Arthur Galstian Md LLC | Obstetrics & Gynecology | 9240 N Meridian St Ste 180, Indianapolis, IN 46260-2065 | 2018-02-27 |
| 1225537319 | Jeannette Colon, M.d., P.C. | Obstetrics & Gynecology | 401 Wall St Unit A, Valparaiso, IN 46383-2585 | 2018-02-05 |
| 1497105761 | Jonathan Alford | Obstetrics & Gynecology | 4660 E 146th Street, Suite 100, Noblesville, IN 46060 | 2016-06-17 |
| 1598113458 | Zachary Christopher Dobbin | Obstetrics & Gynecology | 10215 Broadway Ste 207, Crown Point, IN 46307-8001 | 2016-06-01 |
| 1821446774 | Jessica Mae Healey | Obstetrics & Gynecology | 1111 Ronald Reagan Pkwy Ste C1400, Avon, IN 46123-7085 | 2016-06-01 |
| 1801240775 | Bridget Marie Kennedy | Obstetrics & Gynecology | 225 S Emmons St, Denver, IN 46926-2300 | 2016-04-18 |
| 1013370485 | Ashley Seidner | Obstetrics & Gynecology | 395 Westfield Rd # B, Noblesville, IN 46060-1425 | 2016-04-01 |
| 1508237272 | Columbus Regional Health Physicians, LLC | Obstetrics & Gynecology | 2450 Northpark Dr, Suite A, Columbus, IN 47203-2292 | 2015-10-07 |
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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.