Active NPI
Donald August Pelsor, MD
- Pediatrics Physician
- Englewood, OH
National Provider Identifier
1467431569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 35 04 3249P
- Practice address
- 120 W Wenger Rd
Englewood, OH 45322 - Phone
- (937) 836-9921
- Fax
- (937) 836-1298
- NPI assigned
- Jan 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35 04 3249P | OH | Primary |
| Pediatrics Physician | 208000000X | 0102335 IN | IN |
Addresses
Primary practice location
120 W Wenger Rd
Englewood, OH 45322
Mailing address
120 W Wenger Rd
Englewood, OH 45322
Phone (937) 836-9921
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000011347 | Other | OH | ANTHEM BCBS |
| 1220023 | Other | OH | UNITED HEALTH CARE |
| 0410531 | Medicaid | OH | |
| D43249 | Other | HUMANA | |
| 2080948 | Medicaid | OH | |
| NO9285501 | Other | GROUP MEDICARE |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102335 IN | IN | MD | Pediatrics Physician |
| 35 04 3249P | OH | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385424000000",
"number": "1467431569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 W WENGER RD",
"city": "ENGLEWOOD",
"state": "OH",
"postal_code": "45322",
"telephone_number": "937-836-9921",
"fax_number": "937-836-1298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 W WENGER RD",
"city": "ENGLEWOOD",
"state": "OH",
"postal_code": "45322",
"telephone_number": "937-836-9921",
"fax_number": "937-836-1298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELSOR",
"first_name": "DONALD",
"middle_name": "AUGUST",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-17",
"last_updated": "2013-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "35 04 3249P",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "0102335 IN",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000011347",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "1220023",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0410531",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "D43249",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2080948",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE",
"identifier": "NO9285501",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Englewood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.