Individual provider Active NPI

Douglas W Teller, MD

  • Internal Medicine Physician
  • Miamisburg, OH
National Provider Identifier
1083696371
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35048745 Issued in OH
Practice address
2115 Leiter Rd
Miamisburg, OH 45342-3600
Phone
(937) 384-6800
Fax
(937) 384-6939
NPI assigned
Nov 14, 2005
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35048745 OH Primary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X 35048745 OH
Addiction Medicine (Internal Medicine) Physician 207RA0401X 35048745 OH
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 35048745 OH

Addresses

Primary practice location

2115 Leiter Rd
Miamisburg, OH 45342-3600

Mailing address

2115 Leiter Rd
Miamisburg, OH 45342-3600
Phone (937) 384-6800

Other identifiers 3

IdentifierTypeStateIssuer
000000330888OtherANTHEM
0664311MedicaidOH
016801000OtherMAGELLAN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dteller24023@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

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
35048745OHMDAdolescent Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1083696371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 LEITER RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423600",
            "telephone_number": "937-384-6800",
            "fax_number": "937-384-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 LEITER RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423600",
            "telephone_number": "937-384-6800",
            "fax_number": "937-384-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLER",
        "first_name": "DOUGLAS",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2026-09-29",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35048745",
            "primary": true
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "OH",
            "license": "35048745",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "OH",
            "license": "35048745",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "OH",
            "license": "35048745",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000330888",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0664311",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "016801000",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dteller24023@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "2115 Leiter Rd",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453423600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2115 Leiter Rd",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453423600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miamisburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.