NPIMap

Individual provider Active NPI

James E. Huizenga, M.D.

  • Emergency Medicine Physician
  • Kettering, OH
National Provider Identifier
1659362697
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35080845 Issued in OH
Practice address
3535 Southern Blvd
Kettering, OH 45429-1221
Phone
(937) 298-3399
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35080845 OH Primary

Addresses

Primary practice location

3535 Southern Blvd
Kettering, OH 45429-1221

Mailing address

8280 Yankee St
Centerville, OH 45458-1806
Phone (937) 436-4658

Other identifiers 3

IdentifierTypeStateIssuer
4122694OtherOHMEDICARE PTAN
2407327MedicaidOH
4122693OtherOHMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35080845OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greene Emergency Medical Services Past Accepting new patients
Samaritan Emergency Corp Emergency Medicine Past Accepting new patients
Professional Emergency Specialists of Southern Ohio Emergency Medicine Past Accepting new patients
West Central Emergency Physicians Emergency Medicine Past Accepting new patients
Professional Emergency Specialists of Southern Ohio Emergency Medicine Past Accepting new patients
Emergency Medicine Specialists Inc Emergency Medicine Past Accepting new patients

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1659362697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8280 YANKEE ST",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454581806",
            "telephone_number": "937-436-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-298-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUIZENGA",
        "first_name": "JAMES",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35080845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "4122694",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2407327",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "4122693",
            "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 Mar 16, 2018; 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.