Mound Family Practice Assoc Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MOUND FAMILY PRACTICE ASSOC INC

Practice address

1012 E Central Ave
Miamisburg, OH 45342-2556

Phone

(937) 866-0741

Fax

(937) 866-8861

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

William Brent Ashcraft, M.D.

Title

President

Phone

(937) 866-0741

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1245324193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 N RIDGE",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450669283",
            "telephone_number": "937-748-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 E CENTRAL AVE",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453422556",
            "telephone_number": "937-866-0741",
            "fax_number": "937-866-8861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUND FAMILY PRACTICE ASSOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "ASHCRAFT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-866-0741",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0959342",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CF1385",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000003291",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.