Individual provider Active NPI

Merlin Paul Ohmer, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • St Augustine, FL
National Provider Identifier
1275513434
Registry record updated Jul 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN 14472 Issued in FL
Practice address
72 Valencia St
St Augustine, FL 32084-3540
Phone
(904) 233-3601
NPI assigned
Jan 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14472 FL
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN 14472 FL Primary

Addresses

Primary practice location

72 Valencia St
St Augustine, FL 32084-3540

Mailing address

72 Valencia St
St Augustine, FL 32084-3540
Phone (904) 233-3601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190108002442 FL Order and Referring Only - DentistPractitioner - Dentist 2062758303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14472FLMDGeneral Practice Dentistry
DN 14472FLMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1137801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467849600000",
    "number": "1275513434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 VALENCIA ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320843540",
            "telephone_number": "904-233-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 VALENCIA ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320843540",
            "telephone_number": "904-233-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHMER",
        "first_name": "MERLIN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-21",
        "last_updated": "2016-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "14472",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN 14472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.