Individual provider Active NPI

Alok Agrawal, MD

  • Nephrology Physician
  • Wilmington, OH
National Provider Identifier
1184606477
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
77552 Issued in OH
Practice address
630 W Main St
Suite 209
Wilmington, OH 45177-2170
Phone
(937) 383-2700
Fax
(937) 383-2722
NPI assigned
Nov 14, 2005
Last updated
Dec 6, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 77552 OH Primary

Addresses

Primary practice location

630 W Main St
Suite 209
Wilmington, OH 45177-2170

Mailing address

630 W Main St
Suite 209
Wilmington, OH 45177-2170
Phone (937) 383-2700

Other identifiers 8

IdentifierTypeStateIssuer
000000074148OtherANTHEM
310821503032OtherCARE SOURCE
D77552OtherHUMANA
2161842MedicaidOH
390007302OtherUHC
3108215037B22OtherUNITED MINE WORKERS
2273021OtherAETNA
390007302OtherMEDICARE RAILROAD

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
77552OHMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Renal Physicians Inc Nephrology Current Accepting new patients
Surmeet Bedi MD LLC Nephrology Past Accepting new patients

Locations

1 Elizabeth Pl
Ste 190
Dayton, OH 45417
Phone (937) 222-3118

455 Turner Rd
Dayton, OH 45415
Phone (937) 294-6711

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1184606477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W MAIN ST",
            "address_2": "SUITE 209",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772170",
            "telephone_number": "937-383-2700",
            "fax_number": "937-383-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W MAIN ST",
            "address_2": "SUITE 209",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772170",
            "telephone_number": "937-383-2700",
            "fax_number": "937-383-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGRAWAL",
        "first_name": "ALOK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "77552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000074148",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE SOURCE",
            "identifier": "310821503032",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "D77552",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2161842",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "390007302",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED MINE WORKERS",
            "identifier": "3108215037B22",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2273021",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "390007302",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.