Individual provider Active NPI

John R Fearon, DO

  • Emergency Medicine Physician
  • Bellefontaine, OH
National Provider Identifier
1003857418
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34002350F Issued in OH
Practice address
205 E Palmer Rd
Bellefontaine, OH 43311-2281
Phone
(937) 592-4015
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34002350F OH Primary

Addresses

Primary practice location

205 E Palmer Rd
Bellefontaine, OH 43311-2281

Mailing address

110 Dowell Ave
Bellefontaine, OH 43311-2305

Other identifiers 9

IdentifierTypeStateIssuer
7755544OtherAETNA
FE0923062OtherTRICARE
000000026809OtherANTHEM
2051587MedicaidOH
87726OtherUHC
010039356OtherRR MEDICARE
341407259OtherCIGNA
341407259OtherNATIONWIDE
341407259037OtherMEDICAL MUTUAL

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
34002350FOHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Rutan Hospital 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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1003857418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 DOWELL AVE",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E PALMER RD",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112281",
            "telephone_number": "937-592-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEARON",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34002350F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7755544",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "FE0923062",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000026809",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2051587",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "87726",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "010039356",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "341407259",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONWIDE",
            "identifier": "341407259",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL",
            "identifier": "341407259037",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellefontaine, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.