NPIMap

Organization Active NPI

Alliance Physician Inc

Doing business as Sycamore Family Medicine

  • Family Medicine Physician
  • Miamisburg, OH
National Provider Identifier
1205118692
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALLIANCE PHYSICIAN INC
Doing business as
Sycamore Family Medicine
Practice address
4000 Miamisburg Centerville Rd
Suite 410B
Miamisburg, OH 45342-7615
Phone
(937) 384-0790
Fax
(937) 384-0794
NPI assigned
Sep 13, 2011
Last updated
Sep 13, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
ALLIANCE PHYSICIAN INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Authorized official

Name
Daniel D Haibach
Title
Director Business Development
Phone
(937) 558-3222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

4000 Miamisburg Centerville Rd
Suite 410B
Miamisburg, OH 45342-7615

Mailing address

2110 Leiter Rd
Miamisburg, OH 45342-3660
Phone (937) 384-4838

Other identifiers 1

IdentifierTypeStateIssuer
2712872MedicaidOH

Other names 1

  • Sycamore Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northeast Family Practi77 organizations share this tax ID, including this one
Part of
Northeast Family Practi

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Locations

4000 Miamisburg Centerville Rd
Ste 410B
Miamisburg, OH 45342
Phone (937) 384-0790

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1205118692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 LEITER RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423660",
            "telephone_number": "937-384-4838",
            "fax_number": "937-384-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MIAMISBURG CENTERVILLE RD",
            "address_2": "SUITE 410B",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453427615",
            "telephone_number": "937-384-0790",
            "fax_number": "937-384-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE PHYSICIAN INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALLIANCE PHYSICIAN INC",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "HAIBACH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "937-558-3222"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2712872",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sycamore Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miamisburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.