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RDM SURGICAL ASSISTANT
NPI 1265054712
Physician Assistant - Surgical in Depauw, IN

Active since May 07, 2020
10081 FREDERICKSBURG RD NW, DEPAUW, IN 47115(812) 267-6695 Get Directions Write a Review

NPPES record last updated: June 4, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 4, 2020, May 7, 2020 (2 updates tracked since 2020).

About Rdm Surgical Assistant NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RDM SURGICAL ASSISTANT (NPI 1265054712) is a healthcare organization registered as a surgical in Depauw, Indiana and active in the NPI registry since May 2020. The organization lists Rebecca Lou Autry, Owner, as its authorized official.

NPPES Registry Identity

NPI1265054712
Entity TypeOrganization
Primary Taxonomy363AS0400X
Legal Business NameRDM SURGICAL ASSISTANT
Location Address10081 FREDERICKSBURG RD NWDepauw, IN 47115-8629
Mailing Address10081 Fredericksburg Rd NwDepauw, IN 47115-8629 · (812) 267-6695
Phone(812) 267-6695
Organization SubpartNo
Authorized OfficialRebecca Lou AutryOwner · (812) 267-6695
Enumeration DateMay 7, 2020
Last NPPES UpdateJune 4, 20202 updates tracked since enumeration
NPPES CertifiedJune 4, 2020
✔ NPI 1265054712 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
10081 FREDERICKSBURG RD NW, Depauw, IN 47115
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. REBECCA LOU BEAUCHAMP PA-C
Physician Assistant
10081 FREDERICKSBURG RD NW
DEPAUW, IN 47115
Harrison County (812) 347-2568
R & L SURGICAL SERVICES
Physician Assistant (Surgical)
10081 FREDERICKSBURG RD NW
DEPAUW, IN 47115
Harrison County (812) 705-4174

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rdm Surgical Assistant's NPI number?

The NPI number for Rdm Surgical Assistant is 1265054712. It was assigned to this organization in the NPPES registry on May 7, 2020.

Where is Rdm Surgical Assistant located?

Rdm Surgical Assistant is located at 10081 Fredericksburg Rd NW, Depauw, IN 47115. The listed phone number is (812) 267-6695.

What is Rdm Surgical Assistant's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Rdm Surgical Assistant was last updated on June 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.