Individual provider Active NPI

Rick W Gebhart, D.O.

  • Family Medicine Physician
  • Vandalia, OH
National Provider Identifier
1306849823
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34005782 Issued in OH
Practice address
505 Corporate Center Dr
Vandalia, OH 45377-1167
Phone
(937) 619-0050
Fax
(937) 619-0069
NPI assigned
May 30, 2005
Last updated
Jan 24, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34005782 OH Primary

Addresses

Primary practice location

505 Corporate Center Dr
Vandalia, OH 45377-1167

Mailing address

1 Prestige PL Ste 550
Miamisburg, OH 45342-6115
Phone (937) 619-0050

Other identifiers 10

IdentifierTypeStateIssuer
23334OtherOHNATIONWIDE HEALTH PLAN
D0578203OtherOHHUMANA/CHOICECARE
0122721OtherOHUNITED HEALTHCARE
080191701OtherOHRAILROAD MEDICARE
0938249MedicaidOH
2192769OtherOHAETNA
302622980900OtherOHOHIO BWC
000000227856OtherOHANTHEM
147240004OtherOHCARESOURCE
34005782OtherOHMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200124001963 OH Order and Referring Only - Family PracticePractitioner - Family Practice 0648208561

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Voca Corp Past Accepting new patients
Voca Corp Past Accepting new patients
Voca Corp Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1117411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1306849823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PRESTIGE PL STE 550",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453426115",
            "telephone_number": "937-619-0050",
            "fax_number": "937-619-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 CORPORATE CENTER DR",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453771167",
            "telephone_number": "937-619-0050",
            "fax_number": "937-619-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBHART",
        "first_name": "RICK",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-30",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34005782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONWIDE HEALTH PLAN",
            "identifier": "23334",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA/CHOICECARE",
            "identifier": "D0578203",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0122721",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080191701",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0938249",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2192769",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO BWC",
            "identifier": "302622980900",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000227856",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "147240004",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "34005782",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vandalia, OH

Sources for this page

Verify at the official NPI Registry.