Active NPI
DB MD WCC LLC
- Surgery Physician
- Middletown, OH
National Provider Identifier
1114398203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 35066726
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daniel A Butler, M.D.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0147591 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151202001681 | OH | Part B Supplier - Clinic/Group Practice | 7416257100 |
Receives reassigned benefits from 1 practitioner Practice locations: Middletown, OH |
National Provider Directory
National Provider DirectoryLocations
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.