NPIMap

Organization Active NPI

Pediatric Associates of Dayton, Inc.

  • Pediatrics Physician
  • Kettering, OH
National Provider Identifier
1609045012
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC ASSOCIATES OF DAYTON, INC.
Practice address
5450 Far Hills Ave
Suite 110
Kettering, OH 45429-2386
Phone
(937) 436-2866
Fax
(937) 436-1468
NPI assigned
Feb 29, 2008
Last updated
Feb 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Authorized official

Name
Dr. Gary Youra, M.D.NPI 1104902329
Title
Physician
Phone
(937) 832-7337

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
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

5450 Far Hills Ave
Suite 110
Kettering, OH 45429-2386

Mailing address

9000 N Main St
Suite 110
Dayton, OH 45415-1180
Phone (937) 832-7337

Other identifiers 1

IdentifierTypeStateIssuer
2637543MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Associates of Dayton Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9000 N Main St
Ste 110
Englewood, OH 45415
Phone (937) 832-7337

Practitioners & affiliated clinicians

Practitioners 2

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": "1204243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1609045012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 N MAIN ST",
            "address_2": "SUITE 110",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151180",
            "telephone_number": "937-832-7337",
            "fax_number": "937-832-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 FAR HILLS AVE",
            "address_2": "SUITE 110",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454292386",
            "telephone_number": "937-436-2866",
            "fax_number": "937-436-1468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF DAYTON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "YOURA",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "937-832-7337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2637543",
            "state": "OH"
        }
    ],
    "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 Feb 29, 2008; 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.