Individual provider Active NPI

Janson Becker, MD

  • Internal Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1073563136
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35056087 Issued in OH
Practice address
4101 Edwards Rd FL 2
Cincinnati, OH 45209-1678
Phone
(513) 981-4646
Fax
(513) 979-2830
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35056087 OH Primary

Addresses

Primary practice location

4101 Edwards Rd FL 2
Cincinnati, OH 45209-1678

Mailing address

4101 Edwards Rd FL 2
Cincinnati, OH 45209-1678
Phone (513) 981-4646

Other practice location 1

4750 E Galbraith Rd
Suite 207
Cincinnati, OH 45236-6705
Phone (513) 686-4840

Other identifiers 2

IdentifierTypeStateIssuer
07078005MedicaidOH
P00324380OtherOHMEDICARE RR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35056087OHMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1073563136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 EDWARDS RD FL 2",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452091678",
            "telephone_number": "513-981-4646",
            "fax_number": "513-979-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 EDWARDS RD FL 2",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452091678",
            "telephone_number": "513-981-4646",
            "fax_number": "513-979-2830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4750 E Galbraith Rd",
            "address_2": "Suite 207",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452366705",
            "country_code": "US",
            "telephone_number": "513-686-4840",
            "fax_number": "513-686-4848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECKER",
        "first_name": "JANSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35056087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07078005",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00324380",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.