Organization Active NPI

Alliance Physician Inc

Doing business as Heritage Family Practice Washington Blvd

  • Family Medicine Physician
  • Hamilton, OH
National Provider Identifier
1457632168
Registry record updated Sep 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALLIANCE PHYSICIAN INC
Doing business as
Heritage Family Practice Washington Blvd
Practice address
903 NW Washington Blvd
Suite B
Hamilton, OH 45013-6386
Phone
(513) 867-9000
Fax
(513) 785-3675
NPI assigned
Sep 8, 2011
Last updated
Sep 8, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
ALLIANCE PHYSICIAN INCEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 8, 2011

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

Authorized official

Name
Daniel D Haibach
Title
Director Business Development
Phone
(937) 558-3222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

903 NW Washington Blvd
Suite B
Hamilton, OH 45013-6386

Mailing address

2110 Leiter Rd
Miamisburg, OH 45342-3660
Phone (937) 384-4838

Other identifiers 1

IdentifierTypeStateIssuer
2712872MedicaidOH

Other names 1

  • Heritage Family Practice Washington Blvd Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northeast Family Practi77 organizations share this tax ID, including this one
Part of
Northeast Family Practi

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

903 NW Washington Blvd
Ste B
Hamilton, OH 45013
Phone (513) 867-9000

Practitioners & affiliated clinicians

Practitioners 5

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": "1315440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315440000000",
    "number": "1457632168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 LEITER RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423660",
            "telephone_number": "937-384-4838",
            "fax_number": "937-384-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 NW WASHINGTON BLVD",
            "address_2": "SUITE B",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450136386",
            "telephone_number": "513-867-9000",
            "fax_number": "513-785-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE PHYSICIAN INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALLIANCE PHYSICIAN INCE",
        "enumeration_date": "2011-09-08",
        "last_updated": "2011-09-08",
        "status": "A",
        "authorized_official_last_name": "HAIBACH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "937-558-3222"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2712872",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Family Practice Washington Blvd",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hamilton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; 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.