Organization Active NPI

Western Ohio Podiatric Medical Center Inc

  • Podiatrist
  • Greenville, OH
National Provider Identifier
1376643411
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
WESTERN OHIO PODIATRIC MEDICAL CENTER INC
Practice address
415 W Russ Rd
Greenville, OH 45331-2457
Phone
(937) 548-1244
Fax
(934) 548-8898
NPI assigned
Sep 25, 2006
Last updated
Nov 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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

Authorized official

Name
Michael Robert Maher, DPMNPI 1114928355
Title
Owner
Phone
(937) 548-1244

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X Primary

Addresses

Primary practice location

415 W Russ Rd
Greenville, OH 45331-2457

Mailing address

415 W Russ Rd
Greenville, OH 45331-2457
Phone (937) 548-1244

Other identifiers 1

IdentifierTypeStateIssuer
2413374MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20051205000892 OH Part B Supplier - Clinic/Group Practice 2466472402 Receives reassigned benefits from 4 practitioners
Practice locations: Greenville, OH
O20100930068685 OH DME Supplier - Physician - Podiatry 2466472402 Practice locations: Greenville, OH
O20151109000962 IN Part B Supplier - Clinic/Group Practice 2466472402 Receives reassigned benefits from 2 practitioners
Practice locations: Greenville, OH

National Provider Directory

National Provider Directory

Locations

415 W Russ Rd
Greenville, OH 45331
Phone (937) 548-1224

5162 Childrens Home Rd
Greenville, OH 45331
Phone (937) 316-8155

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/89qRxg50XNEvJ1rMzQ6E1GUFVYLjKcWl/

Practitioners & affiliated clinicians

Practitioners 6

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": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447027200000",
    "number": "1376643411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W RUSS RD",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453312457",
            "telephone_number": "937-548-1244",
            "fax_number": "934-548-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W RUSS RD",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453312457",
            "telephone_number": "937-548-1244",
            "fax_number": "934-548-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN OHIO PODIATRIC MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2015-11-09",
        "status": "A",
        "authorized_official_last_name": "MAHER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-548-1244",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2413374",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.