Active NPI
Executive Urology
- Urology Physician
- Norwalk, OH
National Provider Identifier
1194049866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- EXECUTIVE UROLOGY
- Practice address
- 278 Benedict Ave
Suite 650
Norwalk, OH 44857-2399 - Phone
- (419) 668-4328
- NPI assigned
- Mar 24, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert W Rice, MD
- Title
- President
- Phone
- (419) 627-8771
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | Primary |
Addresses
Primary practice location
278 Benedict Ave
Suite 650
Norwalk, OH 44857-2399
Mailing address
2800 Hayes Ave
BLDG D
Sandusky, OH 44870-7248
Phone (419) 627-8771
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2281972 | Medicaid | OH | |
| CG9157 | Other | OH | RAILROAD MEDICARE |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D1013354 | Executive Urology of Fisher-Titus | Certificate of waiver | Jun 8, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Executive Urology
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Urology Physician
- Bellevue, OH
- NPI 1649594318
Locations
278 Benedict Ave
Ste 650
Norwalk, OH 44857
Phone (419) 660-9675
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269388800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1269388800000",
"number": "1194049866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 HAYES AVE",
"address_2": "BLDG D",
"city": "SANDUSKY",
"state": "OH",
"postal_code": "448707248",
"telephone_number": "419-627-8771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "278 BENEDICT AVE",
"address_2": "SUITE 650",
"city": "NORWALK",
"state": "OH",
"postal_code": "448572399",
"telephone_number": "419-668-4328"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EXECUTIVE UROLOGY",
"organizational_subpart": "NO",
"enumeration_date": "2010-03-24",
"last_updated": "2010-03-24",
"status": "A",
"authorized_official_last_name": "RICE",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "419-627-8771",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2281972",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CG9157",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Norwalk, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.