Individual provider Active NPI

Harold Todd Kepler, DO

  • Family Medicine Physician
  • Youngstown, OH
National Provider Identifier
1053368910
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34-004320-K Issued in OH
Practice address
3551 Belmont Ave Ste 19B
Youngstown, OH 44505-1439
Phone
(330) 222-4030
NPI assigned
May 27, 2006
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34-004320-K OH Primary

Addresses

Primary practice location

3551 Belmont Ave Ste 19B
Youngstown, OH 44505-1439

Mailing address

PO Box 746071
Atlanta, GA 30374-6071
Phone (312) 733-9730

Other practice location 1

3525 Blossom Heath Rd
Dayton, OH 45419-1106
Phone (937) 239-5888

Other practice location 2

3096 Cleveland Ave
Columbus, OH 43224-3682
Phone (614) 493-0846

Other identifiers 1

IdentifierTypeStateIssuer
0743502MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100125000086 OH Practitioner - Family Practice 1355483785 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34-004320-KOHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Family Care Inc Family Medicine CurrentSince Dec 1, 2016 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Equitas Health,Inc Past Accepting new patients

Locations

1530 Needmore Rd
Ste 200
Dayton, OH 45414
Phone (937) 278-5854

8638 Old Troy Pike
Ste A
Huber Heights, OH 45424
Phone (937) 237-1574

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1053368910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746071",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746071",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 BELMONT AVE STE 19B",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051439",
            "telephone_number": "330-222-4030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3525 Blossom Heath Rd",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454191106",
            "country_code": "US",
            "telephone_number": "937-239-5888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3096 Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432243682",
            "country_code": "US",
            "telephone_number": "614-493-0846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEPLER",
        "first_name": "HAROLD",
        "middle_name": "TODD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34-004320-K",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0743502",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.