Organization Active NPI

Urologic Physicians & Surgeons Inc.

  • Urology Physician
  • Beavercreek, OH
National Provider Identifier
1528066602
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
UROLOGIC PHYSICIANS & SURGEONS INC.
Practice address
2145 N Fairfield Rd
Suite B
Beavercreek, OH 45431-2580
Phone
(937) 429-7352
Fax
(937) 429-3772
NPI assigned
Jul 12, 2005
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
Jack R Pence II, MDNPI 1851399414
Title
President
Phone
(937) 429-7352

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X OH Primary

Addresses

Primary practice location

2145 N Fairfield Rd
Suite B
Beavercreek, OH 45431-2580

Mailing address

2145 N Fairfield Rd
Suite B
Beavercreek, OH 45431-2580
Phone (937) 429-7352

National Provider Directory

National Provider Directory

Locations

2145 N Fairfield Rd
Ste B
Beavercreek, OH 45431
Phone (937) 208-2540

4940 Cottonville Rd
Ste 600
Jamestown, OH 45335
Phone (937) 435-4263

Practitioners & affiliated clinicians

Practitioners 1

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": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1528066602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 N FAIRFIELD RD",
            "address_2": "SUITE B",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312580",
            "telephone_number": "937-429-7352",
            "fax_number": "937-429-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 N FAIRFIELD RD",
            "address_2": "SUITE B",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312580",
            "telephone_number": "937-429-7352",
            "fax_number": "937-429-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGIC PHYSICIANS & SURGEONS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PENCE",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-429-7352",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.