Montgomery Family Practice, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

350728718 Issued in OH

Legal business name

MONTGOMERY FAMILY PRACTICE, INC

Practice address

10550 Montgomery Rd Ste 11
Montgomery, OH 45242-4495

Phone

(513) 791-1201

Fax

(513) 791-1231

NPI assigned

Nov 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ginger S Kubala, MDNPI 1952441891

Title

President MD

Phone

(513) 791-1201

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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

• Ginger S Kubala, MD

  • Family Medicine Physician
  • Cincinnati, OH
  • NPI 1952441891
  Medicare reassignment Care Compare group NPD Authorized official
• Anthony W10 Brown, MD

  • Family Medicine Physician
  • Cincinnati, OH
  • NPI 1417097361
  Medicare reassignment Care Compare group NPD
• William Randall Cox, MD

  • Family Medicine Physician
  • Cincinnati, OH
  • NPI 1902946858
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1144390345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10550 MONTGOMERY RD",
            "address_2": "# 12",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45242",
            "telephone_number": "513-791-1201",
            "fax_number": "513-791-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10550 MONTGOMERY RD STE 11",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452424495",
            "telephone_number": "513-791-1201",
            "fax_number": "513-791-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY FAMILY PRACTICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2023-01-11",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "KUBALA",
        "authorized_official_first_name": "GINGER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT MD",
        "authorized_official_telephone_number": "513-791-1201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35057045",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35067638",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "350728718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2274891",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Khurram R Mirza, MD
• James Joseph Misocky Jr., D.P.M.
• Erica Shawnta Mitchell, AGACNP- BC
• Sarah Louise Miter, MD
• Montgomery Counseling Center, LLC
• Brianna Nicole Montgomery, LMT
• Margaret A. Moon, M.D.
• Alyssa K Moore, PA-C
• Anika Tene Moore, MD
• Christine Moore, WHNP-BC

• Family Medicine Physician in Montgomery, OH
• Providers in Montgomery, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.