NPIMap

Organization Active NPI

Pulmonary Medicine of Dayton Inc.

Doing business as Pulmonary & Medicine of Dayton

  • Pulmonary Disease Physician
  • Miamisburg, OH
National Provider Identifier
1205806403
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
PULMONARY MEDICINE OF DAYTON INC.
Doing business as
Pulmonary & Medicine of Dayton
Practice address
4000 Miamisburg Centerville Rd Ste 405
Miamisburg, OH 45342-7615
Phone
(937) 439-3600
Fax
(937) 741-8366
NPI assigned
Jan 23, 2006
Last updated
May 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Katie Adcock
Title
Practice Manager
Phone
(937) 439-3600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OH
Pulmonary Disease Physician 207RP1001X OH Primary

Addresses

Primary practice location

4000 Miamisburg Centerville Rd Ste 405
Miamisburg, OH 45342-7615

Mailing address

PO Box 933242
Cleveland, OH 44193-0035
Phone (937) 439-3600

Other identifiers 1

IdentifierTypeStateIssuer
2194129MedicaidOH

Other names 1

  • Pulmonary & Medicine of Dayton Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031216000899 OH Part B Supplier - Clinic/Group Practice 9335046481 Receives reassigned benefits from 15 practitioners
Practice locations: Kettering, OH; Miamisburg, OH

National Provider Directory

National Provider Directory

Locations

3535 Southern Blvd
Ste 5800
Kettering, OH 45429
Phone (937) 439-3600

4000 Miamisburg Centerville Rd
Ste 405
Miamisburg, OH 45342
Phone (937) 439-3600

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1205806403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933242",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930035",
            "telephone_number": "937-439-3600",
            "fax_number": "937-439-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MIAMISBURG CENTERVILLE RD STE 405",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453427615",
            "telephone_number": "937-439-3600",
            "fax_number": "937-741-8366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULMONARY MEDICINE OF DAYTON INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-23",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "ADCOCK",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "937-439-3600"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2194129",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pulmonary & Medicine of Dayton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pulmonary & Medicine of Dayton",
            "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 May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.