NPIMap

Organization Active NPI

Mill Valley Pediatrics, Inc.

  • Pediatrics Physician
  • Marysville, OH
National Provider Identifier
1174718985
Registry record updated Sep 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
34-007098 Issued in OH
Legal business name
MILL VALLEY PEDIATRICS, INC.
Practice address
1140 Charles LN
Marysville, OH 43040-9797
Phone
(937) 578-4210
NPI assigned
Sep 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2007

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

Authorized official

Name
Dr. James Michael Underwood, D.O.NPI 1558365957
Title
President
Phone
(937) 578-4210

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 34-007098 OH Primary

Addresses

Primary practice location

1140 Charles LN
Marysville, OH 43040-9797

Mailing address

200 Bradenton Ave
Dublin, OH 43017-7515
Phone (614) 793-1980

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189728000000",
    "number": "1174718985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BRADENTON AVE",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430177515",
            "telephone_number": "614-793-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 CHARLES LN",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430409797",
            "telephone_number": "937-578-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILL VALLEY PEDIATRICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-14",
        "last_updated": "2007-09-14",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-578-4210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34-007098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.