Executive Medical Centers of Ohio

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EXECUTIVE MEDICAL CENTERS OF OHIO

Practice address

105 Sugar Camp Cir Ste 140
Oakwood, OH 45409-1979

Phone

(937) 395-3622

Fax

(937) 395-3646

NPI assigned

Dec 15, 2020

Organization subpart

No

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

Authorized official

Name

Barry Edward Taylor, MDNPI 1245279728

Title

President

Phone

(937) 395-3622

Specialties & licenses 1

Addresses

Other names 1

• Executive Medical Centers of Ohio Other name

Electronic endpoints 1

Locations

Practitioners 2

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.

• Barry E. Taylor, MD

  • Internal Medicine Physician
  • Dayton, OH
  • NPI 1245279728
  NPD Authorized official
• Beth E Duvall, MD

  • Internal Medicine Physician
  • Oakwood, OH
  • NPI 1891772216
  NPD (past)

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607990400000",
    "number": "1275129272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SUGAR CAMP CIR STE 140",
            "city": "OAKWOOD",
            "state": "OH",
            "postal_code": "454091979",
            "telephone_number": "937-395-3622",
            "fax_number": "937-395-3646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SUGAR CAMP CIR STE 140",
            "city": "OAKWOOD",
            "state": "OH",
            "postal_code": "454091979",
            "telephone_number": "937-395-3622",
            "fax_number": "937-395-3646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE MEDICAL CENTERS OF OHIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-395-3622",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@emcohio.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "e-mail",
            "address_1": "105 Sugar Camp Cir Ste 140",
            "city": "Oakwood",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454091979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Executive Medical Centers of Ohio",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Compunet Clinical Laboratories, LLC
• Bryn Cortez
• Mitzi Davis, LMT
• Ronda Doster, MS LPC
• Beth E Duvall, MD
• Jennifer Fowler, OD
• Kathleen Fraser, LISW-S
• Brenna Marie Gingrich, NP
• Barry L. Gridley, O.D.
• John J Haluschak, MD

• Internal Medicine Physician in Oakwood, OH
• Providers in Oakwood, 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 Dec 15, 2020; 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.