Kevin G Malloy MD, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

KEVIN G MALLOY MD, LLC

Practice address

5250 Far Hills Ave
Ste 250
Kettering, OH 45429-2353

Phone

(937) 435-6500

Fax

(937) 435-6514

NPI assigned

May 18, 2006

Organization subpart

No

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

Authorized official

Name

Kevin G Malloy, MD

Title

Owner

Phone

(937) 435-6500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003869199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 FAR HILLS AVE",
            "address_2": "STE 250",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454292353",
            "telephone_number": "937-435-6500",
            "fax_number": "937-435-6514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 FAR HILLS AVE",
            "address_2": "STE 250",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454292353",
            "telephone_number": "937-435-6500",
            "fax_number": "937-435-6514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN G MALLOY MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MALLOY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-435-6500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.