NPIMap

Organization Active NPI

Surgical Associates of Greene County Inc

  • Surgery Physician
  • Xenia, OH
National Provider Identifier
1124065396
Registry record updated Aug 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
S2-278069 Issued in OH
Legal business name
SURGICAL ASSOCIATES OF GREENE COUNTY INC
Practice address
244 Wilson Dr
Xenia, OH 45385-1864
Phone
(937) 372-1602
Fax
(937) 372-0154
NPI assigned
May 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2008

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

Authorized official

Name
Pamela McEldowney
Title
Office Manager
Phone
(937) 372-1602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X S2-278069 OH Primary

Addresses

Primary practice location

244 Wilson Dr
Xenia, OH 45385-1864

Mailing address

244 Wilson Dr
Xenia, OH 45385-1864
Phone (937) 372-1602

Other identifiers 7

IdentifierTypeStateIssuer
110019187OtherOHMEDICARE RAILROAD
110019187OtherOHUNITED MINE WORKERS
02193117OtherNYNY MEDICAID
2449MedicaidOH
D47861OtherOHCHOICECARE HUMANA
0976225MedicaidOH
65928137OtherKYKY MEDICAID

National Provider Directory

National Provider Directory

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": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1124065396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 WILSON DR",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453851864",
            "telephone_number": "937-372-1602",
            "fax_number": "937-372-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 WILSON DR",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453851864",
            "telephone_number": "937-372-1602",
            "fax_number": "937-372-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ASSOCIATES OF GREENE COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "MCELDOWNEY",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "937-372-1602"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "OH",
            "license": "S2-278069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110019187",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED MINE WORKERS",
            "identifier": "110019187",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY MEDICAID",
            "identifier": "02193117",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2449",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHOICECARE HUMANA",
            "identifier": "D47861",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0976225",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICAID",
            "identifier": "65928137",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Xenia, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; 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.