Individual provider Active NPI

Robert Earl Ley III, MD

  • Family Medicine Physician
  • Dover, OH
National Provider Identifier
1184601031
Registry record updated Nov 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34034701L Issued in OH
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

Updated by the provider on Nov 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0303540MedicaidOH

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

LicenseStateTypeSpecialty
34034701LOHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital Medical Services, LLC Past Accepting new patients
Union Physician Services, LLC Family Medicine Past Accepting new patients

Interoperability endpoints

  • FHIR API: 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.

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.

Verify at the official NPI Registry.