Individual provider Active NPI

Douglas E. Romer, MD

  • Family Medicine Physician
  • Dayton, OH
National Provider Identifier
1104883073
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-04-9202-R Issued in OH
Practice address
6551 Centerville Business Pkwy Ste 100
Dayton, OH 45459-2696
Phone
(937) 291-6830
Fax
(937) 291-6893
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-04-9202-R OH Primary

Addresses

Primary practice location

6551 Centerville Business Pkwy Ste 100
Dayton, OH 45459-2696

Mailing address

25 Merchant Street
Suite 220 - Attn: Credentialing
Cincinnati, OH 45246-3740
Phone (513) 533-1199

Other identifiers 1

IdentifierTypeStateIssuer
0535844MedicaidOH

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

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1104883073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MERCHANT STREET",
            "address_2": "SUITE 220 - ATTN: CREDENTIALING",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452463740",
            "telephone_number": "513-533-1199",
            "fax_number": "513-645-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6551 CENTERVILLE BUSINESS PKWY STE 100",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454592696",
            "telephone_number": "937-291-6830",
            "fax_number": "937-291-6893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMER",
        "first_name": "DOUGLAS",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-04-9202-R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0535844",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.