Individual provider Active NPI

Gary Michael Youra, MD

  • Pediatric Adolescent Medicine Physician
  • Dayton, OH
National Provider Identifier
1104902329
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
35047499 Issued in OH
Practice address
9000 North Main Street
Suite 332
Dayton, OH 45415-1185
Phone
(937) 832-7337
Fax
(937) 832-4817
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 35047499 OH Primary

Addresses

Primary practice location

9000 North Main Street
Suite 332
Dayton, OH 45415-1185

Mailing address

9000 North Main Street
Suite 332
Dayton, OH 45415-1185
Phone (937) 832-7337

Other identifiers 8

IdentifierTypeStateIssuer
0502969OtherBUREAU FOR CHILDREN WITH
203969OtherNATIONWIDE
1220171OtherUNITED HEALTHCARE
000000037307OtherBLUE CROSS BLUE SHIELD
D47499OtherHUMANA CHOICECARE
0502969MedicaidOH
0633580OtherAETNA
311627276028OtherCARESOURCE

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35047499OHMDPediatric Adolescent Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104902329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 NORTH MAIN STREET",
            "address_2": "SUITE 332",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151185",
            "telephone_number": "937-832-7337",
            "fax_number": "937-832-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 NORTH MAIN STREET",
            "address_2": "SUITE 332",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151185",
            "telephone_number": "937-832-7337",
            "fax_number": "937-832-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOURA",
        "first_name": "GARY",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "OH",
            "license": "35047499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUREAU FOR CHILDREN WITH",
            "identifier": "0502969",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONWIDE",
            "identifier": "203969",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1220171",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000037307",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA CHOICECARE",
            "identifier": "D47499",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0502969",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0633580",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "311627276028",
            "state": null
        }
    ],
    "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 8, 2007; 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.