Individual provider Active NPI

Channhu Trinh, MD

  • Family Medicine Physician
  • Beavercreek, OH
National Provider Identifier
1427032952
Registry record updated Apr 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35087874 Issued in OH
Practice address
3371 Kemp Rd
Beavercreek, OH 45431-2514
Phone
(937) 458-4200
Fax
(937) 458-4209
NPI assigned
Nov 29, 2005
Last updated
Apr 5, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01048969A IN
Family Medicine Physician 207Q00000X 35087874 OH Primary

Addresses

Primary practice location

3371 Kemp Rd
Beavercreek, OH 45431-2514

Mailing address

2933 Maginn Dr
Beavercreek, OH 45434-5831
Phone (740) 644-3037

Other identifiers 3

IdentifierTypeStateIssuer
200335580MedicaidIN
2663667MedicaidOH
P01034947OtherRAILROAD MEDICARE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20161105000039 FL Order and Referring Only - Family PracticePractitioner - Family Practice 4789652801

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01048969AINMDFamily Medicine Physician
35087874OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 1

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365120000000",
    "number": "1427032952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2933 MAGINN DR",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454345831",
            "telephone_number": "740-644-3037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3371 KEMP RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312514",
            "telephone_number": "937-458-4200",
            "fax_number": "937-458-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRINH",
        "first_name": "CHANNHU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2013-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01048969A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35087874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200335580",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2663667",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P01034947",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.