Active NPI
Robert Earl Ley III, MD
- Family Medicine Physician
- Dover, OH
National Provider Identifier
1184601031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34034701L
- Practice address
- 420 Reeves Ave
Suite C
Dover, OH 44622-2162 - Phone
- (330) 364-7791
- Fax
- (330) 343-5066
- NPI assigned
- Dec 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34034701L | OH | Primary |
Addresses
Primary practice location
420 Reeves Ave
Suite C
Dover, OH 44622-2162
Mailing address
420 Reeves Ave
Suite C
Dover, OH 44622-2162
Phone (330) 364-7791
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0303540 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34034701L | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Union Hospital Medical Services, LLC | Past | Accepting new patients | |
| Union Physician Services, LLC | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HDGCDA
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Otolaryngology Physician
- Dover, OH
- NPI 1255567814
-
- Family Medicine Physician
- Dover, OH
- NPI 1215169826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257379200000",
"number": "1184601031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 REEVES AVE",
"address_2": "SUITE C",
"city": "DOVER",
"state": "OH",
"postal_code": "446222162",
"telephone_number": "330-364-7791",
"fax_number": "330-343-5066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 REEVES AVE",
"address_2": "SUITE C",
"city": "DOVER",
"state": "OH",
"postal_code": "446222162",
"telephone_number": "330-364-7791",
"fax_number": "330-343-5066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEY",
"first_name": "ROBERT",
"middle_name": "EARL",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-30",
"last_updated": "2009-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "34034701L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0303540",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dover, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.