Jose R Villavicencio, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35069935V Issued in OH

Practice address

601 St RT 664
Logan, OH 43138

Phone

(740) 380-8000

NPI assigned

May 12, 2006

Last updated

May 29, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Circleville Emergency Physicians Inc.

  • Emergency Medicine Physician
  • Circleville, OH
  • NPI 1770583833
  NPD (past)
• Hocking Emergency Physicians Inc

  • Emergency Medicine Physician
  • Logan, OH
  • NPI 1558362582
  NPD (past)
• Mid-Ohio Emergency Services, LLC

  dba Moes

  • Emergency Medicine Physician
  • Columbus, OH
  • NPI 1386691780
  NPD (past)
• Greenbrier Emergency Services, Inc.

  • Emergency Medicine Physician
  • Gassaway, WV
  • NPI 1568401461
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1265483580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ST RT 664",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "43138",
            "telephone_number": "740-380-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAVICENCIO",
        "first_name": "JOSE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35069935V",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000326505",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOCKING MEDICARE RR",
            "identifier": "P00139007",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacie Dawn Vecchiarelli, M.A.CCC-SLP
• Jackie Vermillion, QMHS
• Joshua L Vermillion, QMHS
• Jennifer Lee Vessalo
• Veteran EMS
• Mario C Villegas, MD
• Desiree Vincent, CMA
• Shana Louise Visintainer
• Makenna L Volquardsen, QMHS
• W. Daniel Alder DDS Ms Inc

• Internal Medicine Physician in Logan, OH
• Providers in Logan, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.