Organization Active NPI

Robert a Kominiarek DO Inc

  • Family Medicine Physician
  • Eaton, OH
National Provider Identifier
1639386089
Registry record updated Apr 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34006547 Issued in OH
Legal business name
ROBERT A KOMINIAREK DO INC
Doing business as
Preble County Family Pracitce
Practice address
450 B Washington Jackson Rd
Suite106
Eaton, OH 45320
Phone
(937) 456-8370
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2010

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

Authorized official

Name
Dr. Robert A Kominiarek, D.O.
Title
Owner
Phone
(937) 456-8370

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 34006547 OH Primary

Addresses

Primary practice location

450 B Washington Jackson Rd
Suite106
Eaton, OH 45320

Mailing address

450 B Washington Jackson Rd
Suite106
Eaton, OH 45320
Phone (937) 456-8370

Other identifiers 1

IdentifierTypeStateIssuer
2065572MedicaidOH

Other names 1

  • Preble County Family Pracitce Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271721600000",
    "number": "1639386089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 B WASHINGTON JACKSON RD",
            "address_2": "SUITE106",
            "city": "EATON",
            "state": "OH",
            "postal_code": "45320",
            "telephone_number": "937-456-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 B WASHINGTON JACKSON RD",
            "address_2": "SUITE106",
            "city": "EATON",
            "state": "OH",
            "postal_code": "45320",
            "telephone_number": "937-456-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT A KOMINIAREK DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2010-04-20",
        "status": "A",
        "authorized_official_last_name": "KOMINIAREK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-456-8370",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34006547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2065572",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Preble County Family Pracitce",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eaton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; 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.