Organization Active NPI

MC Psychiatry LLC

  • Psychiatry Physician
  • Montgomery, OH
National Provider Identifier
1598036972
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35089261 Issued in OH
Legal business name
MC PSYCHIATRY LLC
Practice address
8885 Weller Rd
Montgomery, OH 45249-2729
Phone
(937) 554-9144
NPI assigned
Jan 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Authorized official

Name
Charles Taylor
Title
Statutory Agent
Phone
(937) 304-5955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 35089261 OH Primary

Addresses

Primary practice location

8885 Weller Rd
Montgomery, OH 45249-2729

Mailing address

8885 Weller Rd
Montgomery, OH 45249-2729
Phone (937) 554-9144

Other identifiers 1

IdentifierTypeStateIssuer
30796526400OtherOHOHIO WORKER'S COMPENSATION

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1598036972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8885 WELLER RD",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452492729",
            "telephone_number": "937-554-9144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8885 WELLER RD",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452492729",
            "telephone_number": "937-554-9144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MC PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "STATUTORY AGENT",
        "authorized_official_telephone_number": "937-304-5955"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35089261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO WORKER'S COMPENSATION",
            "identifier": "30796526400",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.