Individual provider Active NPI

William F. Pomputius Jr., MD

  • Family Medicine Physician
  • Mount Vernon, OH
National Provider Identifier
1659512929
Registry record updated May 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
041306 Issued in OH
Practice address
602 North Gay Street
Mount Vernon, OH 43050-1710
Phone
(740) 392-9667
NPI assigned
Mar 17, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 041306 OH Primary

Addresses

Primary practice location

602 North Gay Street
Mount Vernon, OH 43050-1710

Mailing address

602 North Gay Street
Mount Vernon, OH 43050-1710
Phone (740) 392-9667

Other identifiers 2

IdentifierTypeStateIssuer
10310808OtherOHBUREAU WORKMANS COMPENSATION (BWC)
0526390MedicaidOH

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
041306OHMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242950400000",
    "number": "1659512929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 NORTH GAY STREET",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430501710",
            "telephone_number": "740-392-9667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 NORTH GAY STREET",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430501710",
            "telephone_number": "740-392-9667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMPUTIUS",
        "first_name": "WILLIAM",
        "middle_name": "F.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-17",
        "last_updated": "2009-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "041306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUREAU WORKMANS COMPENSATION (BWC)",
            "identifier": "10310808",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0526390",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2009; 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.