Mt Victory Family Practice LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34005413R Issued in OH

Legal business name

MT VICTORY FAMILY PRACTICE LLC

Practice address

460 S Main St
Mt Victory, OH 43340

Phone

(937) 354-2028

Fax

(934) 354-2029

NPI assigned

Feb 5, 2007

Last updated

Jun 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Holly R Recob, DONPI 1659466720

Title

Physician

Phone

(937) 354-2028

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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.

• Holly R Recob, DO

  • Family Medicine Physician
  • Mount Victory, OH
  • NPI 1659466720
  Authorized official Same address or phone

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1245379494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 S MAIN ST",
            "city": "MT VICTORY",
            "state": "OH",
            "postal_code": "43340",
            "telephone_number": "937-354-2028",
            "fax_number": "934-354-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 S MAIN ST",
            "city": "MT VICTORY",
            "state": "OH",
            "postal_code": "43340",
            "telephone_number": "937-354-2028",
            "fax_number": "934-354-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT VICTORY FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "RECOB",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "937-354-2028",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34005413R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0937795",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joyce Arnett Umbrella Holdings
• Hannah Kish
• Alexis Ann Lingrel
• Andrea Jean McCullough, R.N.
• Johnathan S. McNeill
• Zoe Elizabeth Nickole Orich - Downey
• Kara Lynn Ramsey, RN
• Holly R Recob, DO
• Ridgemont Local School District
• Keri Rennee Robinson, M.A.ED., BCBA, COBA

• Family Medicine Physician in Mount Victory, OH
• Providers in Mount Victory, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.