NPIMap

Organization Active NPI

Alliance Physicians Inc

Doing business as Southwest Ohio Urogynecology

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Centerville, OH
National Provider Identifier
1013256981
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
Legal business name
ALLIANCE PHYSICIANS INC
Doing business as
Southwest Ohio Urogynecology
Practice address
7756 Washington Village Dr
Suite 135
Centerville, OH 45459-3999
Phone
(937) 436-9825
Fax
(937) 433-6508
NPI assigned
Feb 12, 2013
Last updated
Oct 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Authorized official

Name
Timothy Y Ko
Title
Cfo
Phone
(937) 558-3223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X NU Primary

Addresses

Primary practice location

7756 Washington Village Dr
Suite 135
Centerville, OH 45459-3999

Mailing address

1 Prestige PL
Suite 550
Miamisburg, OH 45342-3794
Phone (937) 752-2305

Other identifiers 1

IdentifierTypeStateIssuer
0082258MedicaidOH

Other names 1

  • Southwest Ohio Urogynecology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031118000529 OH Part B Supplier - Clinic/Group Practice 0840104360 Receives reassigned benefits from 528 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 25

National Provider Directory

National Provider Directory

Locations

424 E Stroop Rd
Unit B
Kettering, OH 45429
Phone (937) 562-2300

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570147200000",
    "number": "1013256981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PRESTIGE PL",
            "address_2": "SUITE 550",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423794",
            "telephone_number": "937-752-2305",
            "fax_number": "937-522-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7756 WASHINGTON VILLAGE DR",
            "address_2": "SUITE 135",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454593999",
            "telephone_number": "937-436-9825",
            "fax_number": "937-433-6508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-12",
        "last_updated": "2019-10-04",
        "status": "A",
        "authorized_official_last_name": "KO",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "937-558-3223"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0082258",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Ohio Urogynecology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southwest Ohio Urogynecology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Centerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.