Organization Active NPI

Executive Urology

  • Urology Physician
  • Norwalk, OH
National Provider Identifier
1194049866
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
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

Updated by the provider on Mar 24, 2010

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)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
2281972MedicaidOH
CG9157OtherOHRAILROAD MEDICARE

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D1013354Executive Urology of Fisher-Titus278 Benedict Ave Suite 650, Norwalk, OH 44857Certificate of waiverJun 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Executive Urology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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.

Verify at the official NPI Registry.