Active NPI
Robert Paul Mervis, DO
- Emergency Medicine Physician
- Lancaster, OH
National Provider Identifier
1346221587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 34003864
- Practice address
- 1201 River Valley Blvd
Lancaster, OH 43130-1653 - Phone
- (740) 687-2273
- Fax
- (740) 687-9059
- NPI assigned
- Nov 7, 2005
- Last updated
- Oct 6, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 34003864 | OH | Primary |
| Family Medicine Physician | 207Q00000X | 34003864 | OH |
Addresses
Primary practice location
1201 River Valley Blvd
Lancaster, OH 43130-1653
Mailing address
1153 E Main St
PO Box 2563
Lancaster, OH 43130-4056
Phone (740) 687-8990
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0588814 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34003864 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairfield Healthcare Professionals Inc | Past | Accepting new patients | |
| Fairfield Emergency Physicians Inc | Emergency Medicine | Past | Accepting new patients |
| Fairfield ER Physicians Dba Fairfield Medical Center Pro Fee | Emergency Medicine | 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.
-
- Emergency Medicine Physician
- Lancaster, OH
- NPI 1598705949
-
- Emergency Medicine Physician
- Lancaster, OH
- NPI 1942233879
-
dba Fairfield Psychiatric Services
- Psychiatry Physician
- Lancaster, OH
- NPI 1255372215
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475712000000",
"number": "1346221587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1153 E MAIN ST",
"address_2": "PO BOX 2563",
"city": "LANCASTER",
"state": "OH",
"postal_code": "431304056",
"telephone_number": "740-687-8990",
"fax_number": "740-687-8230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 RIVER VALLEY BLVD",
"city": "LANCASTER",
"state": "OH",
"postal_code": "431301653",
"telephone_number": "740-687-2273",
"fax_number": "740-687-9059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERVIS",
"first_name": "ROBERT",
"middle_name": "PAUL",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-07",
"last_updated": "2016-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OH",
"license": "34003864",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "34003864",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0588814",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lancaster, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.