Organization Active NPI

DB MD WCC LLC

  • Surgery Physician
  • Middletown, OH
National Provider Identifier
1114398203
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35066726 Issued in OH
Legal business name
DB MD WCC LLC
Practice address
1 Medical Center Dr
Middletown, OH 45005-2584
Phone
(513) 843-7632
Fax
(513) 843-7945
NPI assigned
Oct 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Authorized official

Name
Daniel A Butler, M.D.NPI 1275523409
Title
Owner
Phone
(513) 843-7632

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 35066726 OH Primary

Addresses

Primary practice location

1 Medical Center Dr
Middletown, OH 45005-2584

Mailing address

3868 McMann Rd Unit a
Cincinnati, OH 45245-2306
Phone (513) 843-7632

Other identifiers 1

IdentifierTypeStateIssuer
0147591MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151202001681 OH Part B Supplier - Clinic/Group Practice 7416257100 Receives reassigned benefits from 1 practitioner
Practice locations: Middletown, OH

National Provider Directory

National Provider Directory

Locations

3868 McMann Rd
Unit A
Cincinnati, OH 45245

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454976000000",
    "number": "1114398203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3868 MCMANN RD UNIT A",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452452306",
            "telephone_number": "513-843-7632",
            "fax_number": "513-843-7945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450052584",
            "telephone_number": "513-843-7632",
            "fax_number": "513-843-7945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DB MD WCC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-14",
        "last_updated": "2016-02-09",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "513-843-7632",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "OH",
            "license": "35066726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0147591",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; 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.

Verify at the official NPI Registry.