Organization Active NPI

Internal Medicine Care, Inc

  • Internal Medicine Physician
  • Eaton, OH
National Provider Identifier
1467532408
Registry record updated Feb 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INTERNAL MEDICINE CARE, INC
Practice address
450B Washington Jackson Rd
Suite 112
Eaton, OH 45320-7600
Phone
(937) 429-0607
Fax
(937) 558-3067
NPI assigned
Oct 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2014

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

Authorized official

Name
Dr. Troy A Tyner, D.O.
Title
President
Phone
(937) 429-0607

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

450B Washington Jackson Rd
Suite 112
Eaton, OH 45320-7600

Mailing address

2510 Commons Blvd
Suite 210
Beavercreek, OH 45431-3820
Phone (937) 429-0607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323000909 OH Part B Supplier - Clinic/Group Practice 8527959113 Receives reassigned benefits from 12 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beavercreek, OH; Dayton, OH

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

450B Washington Jackson Rd
Ste 112
Eaton, OH 45320
Phone (513) 829-7133

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392336000000",
    "number": "1467532408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 COMMONS BLVD",
            "address_2": "SUITE 210",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313820",
            "telephone_number": "937-429-0607",
            "fax_number": "937-558-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450B WASHINGTON JACKSON RD",
            "address_2": "SUITE 112",
            "city": "EATON",
            "state": "OH",
            "postal_code": "453207600",
            "telephone_number": "937-429-0607",
            "fax_number": "937-558-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2014-02-14",
        "status": "A",
        "authorized_official_last_name": "TYNER",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-429-0607",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eaton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.