Individual provider Active NPI

Doris A Myers, DO

  • Gastroenterology Physician
  • Painesville, OH
National Provider Identifier
1598787319
Registry record updated Oct 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
34003594M Issued in OH
Practice address
7551 Fredle Dr
Painesville, OH 44077-9406
Phone
(440) 350-9595
Fax
(440) 357-1905
NPI assigned
Jul 24, 2006
Last updated
Oct 15, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 34003594M OH Primary

Addresses

Primary practice location

7551 Fredle Dr
Painesville, OH 44077-9406

Mailing address

7551 Fredle Drive
Concord, OH 44077
Phone (440) 350-9595

Other identifiers 1

IdentifierTypeStateIssuer
0617407MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101027001351 OH Practitioner - GastroenterologyPractitioner - Internal Medicine 7719171321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34003594MOHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Concepts in Endoscopy Gastroenterology Current Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224028800000",
    "number": "1598787319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7551 FREDLE DRIVE",
            "city": "CONCORD",
            "state": "OH",
            "postal_code": "44077",
            "telephone_number": "440-350-9595",
            "fax_number": "440-357-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7551 FREDLE DR",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440779406",
            "telephone_number": "440-350-9595",
            "fax_number": "440-357-1905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "DORIS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2008-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "34003594M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0617407",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Painesville, OH

Sources for this page

Verify at the official NPI Registry.