Southmoor Medical Associates

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SOUTHMOOR MEDICAL ASSOCIATES

Practice address

38 Southmoor Cir NE
Kettering, OH 45429-2443

Phone

(937) 294-4487

Fax

(937) 294-2255

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Jerome Hochwalt

Title

President

Phone

(937) 294-4487

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1336264209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 SOUTHMOOR CIR NE",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454292443",
            "telephone_number": "937-294-4487",
            "fax_number": "937-294-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 SOUTHMOOR CIR NE",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454292443",
            "telephone_number": "937-294-4487",
            "fax_number": "937-294-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHMOOR MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "HOCHWALT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "JEROME",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-294-4487",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0198772",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Debra K Sowald, PSYD
• Timothy Spaeth
• Sarah Ardella Speciale, LMT
• Janine M Speck, CRNA

• Family Medicine Physician in Kettering, OH
• Providers in Kettering, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; 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.