Maple Leaf Family and Sports Medicine, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MAPLE LEAF FAMILY AND SPORTS MEDICINE, LLC

Practice address

2211 Timber Trail
Bellefontaine, OH 43311

Phone

(937) 592-3808

Fax

(937) 593-8404

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Boyd C Hoddinott, MDNPI 1699765172

Title

Partner

Phone

(937) 592-3808

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JAAAAA

Practitioners 9

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.

• Kristen Theobald Braig, MD

  • Family Medicine Physician
  • Bellefontaine, OH
  • NPI 1265422950
  Medicare reassignment Care Compare group NPD
• John C O'Connor, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Bellefontaine, OH
  • NPI 1184600512
  Medicare reassignment Care Compare group NPD
• Alice Lynn Risner, CNP

  • Family Nurse Practitioner
  • Marion, OH
  • NPI 1164984746
  Medicare reassignment Care Compare group NPD
• Kimberly Maureen Vanover-Bardo, FNP

  • Family Nurse Practitioner
  • Wapakoneta, OH
  • NPI 1902694714

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Kathleen Jeanette Miller, FNP

  • Family Nurse Practitioner
  • West Liberty, OH
  • NPI 1194971911
  Medicare reassignment NPD
• Carolyn Marie Ricketts, MSN, CNP, FNP-BC

  • Family Nurse Practitioner
  • Marysville, OH
  • NPI 1316613276
  Medicare reassignment NPD
• Samuel Barnard

  • Physician Assistant
  • Bellefontaine, OH
  • NPI 1366942542
  Medicare reassignment
• Erick Nazareno, PA-C

  • Physician Assistant
  • Troy, OH
  • NPI 1720761513
  Medicare reassignment
• Boyd Clifford Hoddinott, MD

  • Sports Medicine (Family Medicine) Physician
  • Bellefontaine, OH
  • NPI 1699765172
  Authorized official Same address or phone

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1447328067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 TIMBER TRAIL",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "43311",
            "telephone_number": "937-592-3808",
            "fax_number": "937-593-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 TIMBER TRAIL",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "43311",
            "telephone_number": "937-592-3808",
            "fax_number": "937-593-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE LEAF FAMILY AND SPORTS MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "HODDINOTT",
        "authorized_official_first_name": "BOYD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "937-592-3808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "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": "2225827",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Maben, LPN
• Clare E Macaulay, D.D.S.
• Stacy Maggart, HIS
• Nima Malakooti, M.D.
• Annette Malone, MD
• Steven Marshall, R. PH.
• Alaina Martin
• Bobbi Jo Martinez, PHARMD
• Jason Martinez, PHARM.D.
• Mary Rutan Hospital (Mad River Internal Medicine)

• Family Medicine Physician in Bellefontaine, OH
• Providers in Bellefontaine, 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 Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.