Individual provider Active NPI

Norman Michael Yaggi, PA C

  • Physician Assistant
  • Kettering, OH
National Provider Identifier
1508848805
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50000783 Issued in OH
Practice address
500 Lincoln Park Blvd
Suite 100
Kettering, OH 45429-6410
Phone
(937) 222-3118
Fax
(937) 222-1436
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50000783 OH Primary

Addresses

Primary practice location

500 Lincoln Park Blvd
Suite 100
Kettering, OH 45429-6410

Mailing address

500 Lincoln Park Blvd
Suite 100
Kettering, OH 45429-6410
Phone (937) 222-3118

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50000783OHMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1508848805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LINCOLN PARK BLVD",
            "address_2": "SUITE 100",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454296410",
            "telephone_number": "937-222-3118",
            "fax_number": "937-222-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LINCOLN PARK BLVD",
            "address_2": "SUITE 100",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454296410",
            "telephone_number": "937-222-3118",
            "fax_number": "937-222-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGGI",
        "first_name": "NORMAN",
        "middle_name": "MICHAEL",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50000783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.