Active NPI
Mvhe Inc
- Family Medicine Physician
- Vandalia, OH
National Provider Identifier
1104879097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- MVHE INC
- Practice address
- 55 Elva CT
Vandalia, OH 45377-1875 - Phone
- (937) 208-7500
- Fax
- (937) 208-7515
- NPI assigned
- May 19, 2006
- Organization subpart
- Yes
- Parent organization
- MVHE INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kenneth Prunier
- Title
- President/Ceo
- Phone
- (937) 208-8213
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
55 Elva CT
Vandalia, OH 45377-1875
Mailing address
55 Elva CT
Vandalia, OH 45377-1875
Phone (937) 208-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0109368 | Medicaid | OH |
Other names 1
- Vandalia Medical Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031217000553 | OH | Part B Supplier - Clinic/Group Practice | 9537066584 |
Receives reassigned benefits from 777 practitioners 47 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Franklin, OH; Huber Heights, OH; Jamestown, OH; Kettering, OH; Lebanon, OH; Liberty Township, OH; Middletown, OH; Monroe, OH… |
Other NPIs on the same Medicare enrollment 47
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- Comprehensive Primary C
Locations
3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1346025600000",
"number": "1104879097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 ELVA CT",
"city": "VANDALIA",
"state": "OH",
"postal_code": "453771875",
"telephone_number": "937-208-7500",
"fax_number": "937-208-7515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 ELVA CT",
"city": "VANDALIA",
"state": "OH",
"postal_code": "453771875",
"telephone_number": "937-208-7500",
"fax_number": "937-208-7515"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MVHE INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MVHE INC",
"enumeration_date": "2006-05-19",
"last_updated": "2012-08-27",
"status": "A",
"authorized_official_last_name": "PRUNIER",
"authorized_official_first_name": "KENNETH",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "937-208-8213"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0109368",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Vandalia Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Vandalia, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.