Organization Active NPI

Ohio Valley Allergy and Asthma Center. LLC.

  • Allergy & Immunology Physician
  • Marietta, OH
National Provider Identifier
1295792398
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
OHIO VALLEY ALLERGY AND ASTHMA CENTER. LLC.
Practice address
400 Matthew St
Suite 101
Marietta, OH 45750-1644
Phone
(740) 373-0669
Fax
(740) 568-5228
NPI assigned
May 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mona Abdelgalil Imam, M.D.NPI 1053351494
Title
Sole Member
Phone
(740) 373-0669

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X OH Primary

Addresses

Primary practice location

400 Matthew St
Suite 101
Marietta, OH 45750-1644

Mailing address

PO Box 386
Marietta, OH 45750-0386
Phone (740) 373-0669

National Provider Directory

National Provider Directory

Locations

400 Matthew St
Ste 203
Marietta, OH 45750
Phone (740) 373-0112

Practitioners & affiliated clinicians

Practitioners 1

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": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295792398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 386",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457500386",
            "telephone_number": "740-373-0669",
            "fax_number": "740-568-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MATTHEW ST",
            "address_2": "SUITE 101",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457501644",
            "telephone_number": "740-373-0669",
            "fax_number": "740-568-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO VALLEY ALLERGY AND ASTHMA CENTER. LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IMAM",
        "authorized_official_first_name": "MONA",
        "authorized_official_middle_name": "ABDELGALIL",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "740-373-0669",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.