NPIMap

Organization Active NPI

South Community Primary Care Inc

  • General Practice Physician
  • Moraine, OH
National Provider Identifier
1326334624
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
SOUTH COMMUNITY PRIMARY CARE INC
Practice address
3095 Kettering Blvd
Moraine, OH 45439
Phone
(937) 531-1974
Fax
(937) 534-1579
NPI assigned
Jun 24, 2011
Last updated
Apr 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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

Authorized official

Name
Carol M SmerzNPI 1770027021
Title
Ceo
Phone
(937) 293-8300

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
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

3095 Kettering Blvd
Moraine, OH 45439

Mailing address

3095 Kettering Blvd
Moraine, OH 45439
Phone (937) 531-1974

National Provider Directory

National Provider Directory

Locations

3095 Kettering Blvd
Ofc
Moraine, OH 45439

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523318400000",
    "number": "1326334624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 KETTERING BLVD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "45439",
            "telephone_number": "937-531-1974",
            "fax_number": "937-534-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 KETTERING BLVD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "45439",
            "telephone_number": "937-531-1974",
            "fax_number": "937-534-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COMMUNITY PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-24",
        "last_updated": "2018-04-10",
        "status": "A",
        "authorized_official_last_name": "SMERZ",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "937-293-8300"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moraine, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; 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.