NPIMap

Organization Active NPI

West Ohio Dermatology, Inc.

  • Dermatology Physician
  • Lima, OH
National Provider Identifier
1619070224
Registry record updated Dec 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35040604 Issued in OH
Legal business name
WEST OHIO DERMATOLOGY, INC.
Practice address
750 W High St Ste 300
Lima, OH 45801-2967
Phone
(419) 229-6781
Fax
(419) 229-3490
NPI assigned
Sep 7, 2006
Last updated
Dec 31, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2019

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

Authorized official

Name
Dr. Michael R Heaphy Sr., MDNPI 1821011057
Title
President
Phone
(419) 229-6781

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35040604 OH Primary
MOHS-Micrographic Surgery Physician 207ND0101X 35040604 OH
Procedural Dermatology Physician 207NS0135X 35040604 OH

Addresses

Primary practice location

750 W High St Ste 300
Lima, OH 45801-2967

Mailing address

750 W High St Ste 300
Lima, OH 45801-2967
Phone (419) 229-6781

Other identifiers 1

IdentifierTypeStateIssuer
0340321MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110505000146 OH Part B Supplier - Clinic/Group Practice 2062697121 Receives reassigned benefits from 5 practitioners
Practice locations: Lima, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577750400000",
    "number": "1619070224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 W HIGH ST STE 300",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458012967",
            "telephone_number": "419-229-6781",
            "fax_number": "419-229-3490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 W HIGH ST STE 300",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458012967",
            "telephone_number": "419-229-6781",
            "fax_number": "419-229-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST OHIO DERMATOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A",
        "authorized_official_last_name": "HEAPHY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-229-6781",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35040604",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "OH",
            "license": "35040604",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "OH",
            "license": "35040604",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0340321",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.