Individual provider Active NPI

Edward Enzhong Xie, M.D.

  • Emergency Medicine Physician
  • Shelby, OH
National Provider Identifier
1063672863
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35.093225 Issued in OH
Practice address
199 W Main St
Shelby, OH 44875-1490
Phone
(419) 342-1730
NPI assigned
Jun 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.093225 OH
Emergency Medicine Physician 207P00000X 35.093225 OH Primary

Addresses

Primary practice location

199 W Main St
Shelby, OH 44875-1490

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

Other identifiers 2

IdentifierTypeStateIssuer
3810026091MedicaidWV
2949386MedicaidOH

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
I20090706000530 OH Practitioner - Family PracticePractitioner - Emergency Medicine 8224189170 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Ohio State University College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Ohio Emergency Group, LLCGroup PAC ID 7810233517, 42 clinicians

Practice addresses (Care Compare)

199 W Main St
Shelby, OH 44875-1490
Phone (419) 342-5015

Hospital & facility affiliations

  • Ohiohealth Shelby Hospital Hospital, Shelby, OH, CCN 361324

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as group
Quality
84.85
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Ohio Emergency Group, LLC Emergency Medicine CurrentSince Feb 1, 2019 Accepting new patients
Valley Emergency Physicians Ohio LLC Emergency Medicine CurrentSince Jul 18, 2012 Accepting new patients
Adena Medical Group LLC Family Medicine Past Accepting new patients
Georgetown Emergency Group PC Inc. Emergency Medicine Past Accepting new patients
Harrison Lake Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

200 Corporate Blvd
Lafayette, LA 70508

1025 Center St
Ashland, OH 44805
Phone (419) 207-2370

425 Home St
Georgetown, OH 45121
Phone (937) 378-6121

1408 Campbell Dr
Ironton, OH 45638
Phone (740) 533-9710

335 Glessner Ave
Mansfield, OH 44903
Phone (419) 522-0320

1365 N Lexington Springmill Rd
Ontario, OH 44906
Phone (419) 520-3000

199 W Main St
Shelby, OH 44875
Phone (419) 342-5015

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1063672863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 W MAIN ST",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448751490",
            "telephone_number": "419-342-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XIE",
        "first_name": "EDWARD",
        "middle_name": "ENZHONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-15",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.093225",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.093225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810026091",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2949386",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, OH

Sources for this page

Verify at the official NPI Registry.