Organization Active NPI

Wilmington Surgical Associates, Inc.

  • Specialist
  • Wilmington, OH
National Provider Identifier
1063501294
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
WILMINGTON SURGICAL ASSOCIATES, INC.
Practice address
691 Kelly Dr
Wilmington, OH 45177-1471
Phone
(937) 383-2401
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Authorized official

Name
Dr. Joy Dawn Leverich, MDNPI 1467423681
Title
President
Phone
(937) 383-2401

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

691 Kelly Dr
Wilmington, OH 45177-1471

Mailing address

691 Kelly Dr
Wilmington, OH 45177-1471
Phone (937) 383-2401

Other identifiers 2

IdentifierTypeStateIssuer
0324670MedicaidOH
CC9837OtherOHRR MEDICARE

National Provider Directory

National Provider Directory

Locations

586 W Main St
Ofc
Wilmington, OH 45177
Phone (937) 382-8500

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1063501294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 KELLY DR",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451771471",
            "telephone_number": "937-383-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 KELLY DR",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451771471",
            "telephone_number": "937-383-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMINGTON SURGICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "LEVERICH",
        "authorized_official_first_name": "JOY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-383-2401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0324670",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CC9837",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; 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.