Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Jeffrey Alan Dedelow, M.D.

Diagnostic Radiology Physician in Bloomington, IN · enumerated 2007.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1376758524

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Registry record

Entity type Individual (Type 1)

Name Jeffrey Alan Dedelow

Credential M.D.

Sex Male

Practice address 514 W 2nd St, Bloomington, IN, 47403

Phone (812) 353-3719

Enumeration date May 11, 2007

Last updated in NPPES Dec 9, 2021

Taxonomy & licenses

207RH0002X Hospice and Palliative Medicine (Internal Medicine) Physician Allopathic & Osteopathic Physicians · License 01069197A (IN) Secondary

2085N0904X Nuclear Radiology Physician Allopathic & Osteopathic Physicians · License 4301089258 (MI) Secondary

2085R0202X Diagnostic Radiology Physician Allopathic & Osteopathic Physicians · License MD026741 (LA) Secondary

2085R0202X Diagnostic Radiology Physician Allopathic & Osteopathic Physicians · License 4301089258 (MI) Secondary

2085R0202X Diagnostic Radiology Physician Allopathic & Osteopathic Physicians · License 35.122017 (OH) Secondary

2085R0202X Diagnostic Radiology Physician Allopathic & Osteopathic Physicians · License 01069197A (IN) Primary

MD · Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential

Other identifiers

Identifier	Type	State	Issuer
1049913	Medicaid	LA	-
04377066	Medicaid	MS	-
201015030	Medicaid	IN	-
P01119545	Other	IN	RAILROAD MEDICARE
5186380	Medicaid	MI	-
0090190	Medicaid	OH	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What specialty is Jeffrey Dedelow?

Jeffrey Dedelow is registered in NPPES with the primary taxonomy of Diagnostic Radiology Physician. The taxonomy code describes the provider's classification and area of specialization for claims and credentialing.

Is this the official NPI registry?

No. NPI Portal is a private site built on public CMS NPPES data. The official registry is npiregistry.cms.hhs.gov, operated by CMS.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2021-12-09.