Active NPI
Fredric Lax, M.D.
- Neurological Surgery Physician
- Lima, OH
National Provider Identifier
1225096399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 35 067534
- Practice address
- 770 W High St
Suite 390
Lima, OH 45801-3990 - Phone
- (419) 996-5202
- NPI assigned
- May 1, 2006
- Last updated
- Mar 30, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 35 067534 | OH | Primary |
Addresses
Primary practice location
770 W High St
Suite 390
Lima, OH 45801-3990
Mailing address
PO Box 931843
Cleveland, OH 44193-0004
Phone (937) 291-7850
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000359907 | Other | OH | ANTHEM BLUE CROSS |
| 0995062 | Medicaid | OH | |
| 341105619-020 | Other | SC | TRICARE SERVICES |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 35 067534 | OH | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health-St Ritas Medical Center LLC | Past | Accepting new patients | |
| Mercy Health Physicians Lima, LLC | Past | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Interoperability endpoints
- fredric.lax@direct.myhealthep.org
Organizations & group practices 3
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.
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- Family Medicine Physician
- Lima, OH
- NPI 1225292865
-
dba DBA Fredric Lax
- Sports Medicine (Neuromusculoskeletal Medicine) Physician
- Lima, OH
- NPI 1215994777
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238371200000",
"number": "1225096399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 931843",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441930004",
"telephone_number": "937-291-7850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 W HIGH ST",
"address_2": "SUITE 390",
"city": "LIMA",
"state": "OH",
"postal_code": "458013990",
"telephone_number": "419-996-5202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAX",
"first_name": "FREDRIC",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-01",
"last_updated": "2009-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "OH",
"license": "35 067534",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "000000359907",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0995062",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE SERVICES",
"identifier": "341105619-020",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lima, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.