NPIMap

Individual provider Active NPI

Kevin P Macy, DO

  • Family Medicine Physician
  • Fairborn, OH
National Provider Identifier
1194763193
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34008784 Issued in OH
Practice address
7790 Dayton Springfield Rd Ste B
Fairborn, OH 45324-1996
Phone
(937) 340-6440
Fax
(937) 340-6441
NPI assigned
Jun 2, 2006
Last updated
Oct 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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 34008784 OH Primary

Addresses

Primary practice location

7790 Dayton Springfield Rd Ste B
Fairborn, OH 45324-1996

Mailing address

3250 Middle Urbana Rd
Springfield, OH 45502-9285
Phone (937) 399-7777

Other identifiers 5

IdentifierTypeStateIssuer
2671695OtherOHUNITEDHEALTHCARE
000000482599OtherOHANTHEM
7978819OtherOHAETNA
2666913MedicaidOH
2900159OtherOHCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060825000027 OH Practitioner - Family Practice 0749283117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Arizona College of Osteopathic Medicine Mid Western University, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Ohio Valley Medical Group LLCGroup PAC ID 4385025451, 11 clinicians

Practice addresses (Care Compare)

2816 Troy Rd
Springfield, OH 45504-4328
Phone (937) 340-6440

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34008784OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Valley Medical Group, LLC Family Medicine CurrentSince Aug 4, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

7790 Dayton Springfield Rd
Ste B
Fairborn, OH 45324
Phone (937) 340-6440

3250 Middle Urbana Rd
Springfield, OH 45502
Phone (937) 399-7777

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1194763193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 MIDDLE URBANA RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455029285",
            "telephone_number": "937-399-7777",
            "fax_number": "937-399-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7790 DAYTON SPRINGFIELD RD STE B",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453241996",
            "telephone_number": "937-340-6440",
            "fax_number": "937-340-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACY",
        "first_name": "KEVIN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34008784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "2671695",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000482599",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7978819",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2666913",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2900159",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairborn, OH

Sources for this page

Verify at the official NPI Registry.