Individual provider Active NPI

James C Zedaker, PAC

  • Physician Assistant
  • Troy, OH
National Provider Identifier
1437102373
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50002173 Issued in OH
Practice address
3130 N Dixie Hwy
Troy, OH 45373-1337
Phone
(937) 440-4600
Fax
(937) 339-4059
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50002173 OH Primary

Addresses

Primary practice location

3130 N Dixie Hwy
Troy, OH 45373-1337

Mailing address

4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (800) 875-0136

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50002173OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Central Emergency Physicians CurrentSince Jul 1, 2006 Accepting new patients
Hles of Ohio Inc Past Accepting new patients
Fairfield Hospitalists Inc Past Accepting new patients
Bobcat Emergency Physicians LLC Physician Assistant Past Accepting new patients

Locations

4750 Hempstead Station Dr
Kettering, OH 45429

3130 N Dixie Hwy
Troy, OH 45373
Phone (937) 440-4000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1437102373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 N DIXIE HWY",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453731337",
            "telephone_number": "937-440-4600",
            "fax_number": "937-339-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEDAKER",
        "first_name": "JAMES",
        "middle_name": "C",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50002173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.