Individual provider Active NPI

Stewart I Adam Jr., MD

  • Otolaryngology Physician
  • Dayton, OH
National Provider Identifier
1225009517
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
35051666 Issued in OH
Practice address
1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2684
Phone
(937) 496-2600
Fax
(937) 496-2610
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 35051666 OH Primary

Addresses

Primary practice location

1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2684

Mailing address

1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2684
Phone (937) 496-2600

Other identifiers 5

IdentifierTypeStateIssuer
0453520OtherAETNA
0581777MedicaidOH
D51666OtherHUMANA
000000004436OtherANTHEM
1020041OtherUNITEDHEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35051666OHMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Ohio ENT Specialists Inc Otolaryngology Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HDIFCD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1225009517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 S PATTERSON BLVD",
            "address_2": "SUITE 400",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022684",
            "telephone_number": "937-496-2600",
            "fax_number": "937-496-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S PATTERSON BLVD",
            "address_2": "SUITE 400",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022684",
            "telephone_number": "937-496-2600",
            "fax_number": "937-496-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAM",
        "first_name": "STEWART",
        "middle_name": "I",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35051666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0453520",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0581777",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "D51666",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000004436",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "1020041",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; 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.