Organization Active NPI

Family Practice Associates of Springfield LLC

  • Family Medicine Physician
  • Springfield, OH
National Provider Identifier
1265492839
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY PRACTICE ASSOCIATES OF SPRINGFIELD LLC
Practice address
2701 Moorefield Rd
Springfield, OH 45502-8207
Phone
(937) 399-6650
Fax
(513) 718-3223
NPI assigned
Mar 27, 2006
Last updated
Oct 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Authorized official

Name
Richard Gordon, MDNPI 1154313609
Title
President
Phone
(937) 399-6650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

2701 Moorefield Rd
Springfield, OH 45502-8207

Mailing address

2701 Moorefield Rd
Springfield, OH 45502-8207

Other identifiers 1

IdentifierTypeStateIssuer
2221750MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040517001357 OH Part B Supplier - Clinic/Group Practice 8820088149 Receives reassigned benefits from 2 practitioners
Practice locations: Springfield, OH

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0350295Family Practice Associates of Springfield, LLC2701 Moorefield Road, Springfield, OH 45502Certificate of waiverJul 30, 2026

National Provider Directory

National Provider Directory

Locations

2701 Moorefield Rd
Springfield, OH 45502
Phone (937) 399-6650

3185 El Camino Dr
Springfield, OH 45503
Phone (866) 344-4946

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1265492839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 MOOREFIELD RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455028207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 MOOREFIELD RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455028207",
            "telephone_number": "937-399-6650",
            "fax_number": "513-718-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE ASSOCIATES OF SPRINGFIELD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-399-6650",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2221750",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.