NPIMap

Organization Active NPI

Hickory Medical Direct Primary Care, LLC

  • Family Medicine Physician
  • Bellefontaine, OH
National Provider Identifier
1295196087
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HICKORY MEDICAL DIRECT PRIMARY CARE, LLC
Practice address
208 W Columbus Ave
Bellefontaine, OH 43311-1434
Phone
(937) 404-2488
Fax
(937) 404-2428
NPI assigned
Mar 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Authorized official

Name
Dr. Ryan D Kauffman, MDNPI 1558302448
Title
Founder
Phone
(937) 404-2488

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

208 W Columbus Ave
Bellefontaine, OH 43311-1434

Mailing address

208 W Columbus Ave
Bellefontaine, OH 43311-1434
Phone (937) 404-2488

National Provider Directory

National Provider Directory

Locations

208 W Columbus Ave
Bellefontaine, OH 43311
Phone (937) 404-2444

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1295196087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 W COLUMBUS AVE",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433111434",
            "telephone_number": "937-404-2488",
            "fax_number": "937-404-2428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 W COLUMBUS AVE",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433111434",
            "telephone_number": "937-404-2488",
            "fax_number": "937-404-2428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKORY MEDICAL DIRECT PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-08",
        "last_updated": "2016-03-08",
        "status": "A",
        "authorized_official_last_name": "KAUFFMAN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "937-404-2488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellefontaine, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; 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.