Organization Active NPI

Southeastern Ohio Physicians, Inc.

  • Surgery Physician
  • Cambridge, OH
National Provider Identifier
1477635480
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SOUTHEASTERN OHIO PHYSICIANS, INC.
Practice address
100 Clark CT
Cambridge, OH 43725-9395
Phone
(740) 432-5685
Fax
(740) 432-3812
NPI assigned
Oct 19, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
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

Authorized official

Name
Debra C Neff
Title
Office Manager
Phone
(740) 432-5685

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X OH Primary

Addresses

Primary practice location

100 Clark CT
Cambridge, OH 43725-9395

Mailing address

100 Clark CT
Cambridge, OH 43725-9395
Phone (740) 432-5685

Other identifiers 1

IdentifierTypeStateIssuer
0440017MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050915000242 OH Part B Supplier - Clinic/Group Practice 7012940521 Receives reassigned benefits from 3 practitioners
Practice locations: Cambridge, OH

National Provider Directory

National Provider Directory

Locations

100 Clark Ct
Cambridge, OH 43725
Phone (614) 432-5685

Practitioners & affiliated clinicians

Practitioners 4

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": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1477635480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CLARK CT",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437259395",
            "telephone_number": "740-432-5685",
            "fax_number": "740-432-3812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CLARK CT",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437259395",
            "telephone_number": "740-432-5685",
            "fax_number": "740-432-3812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN OHIO PHYSICIANS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NEFF",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "740-432-5685"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0440017",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, 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.
  • 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.