Active NPI
Robert Edward Kneisley, M.D.
- Family Medicine Physician
- Springfield, OH
National Provider Identifier
1679598163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35042766
- Practice address
- 247 S Burnett Rd
Suite 210
Springfield, OH 45505-2639 - Phone
- (937) 328-8850
- Fax
- (937) 328-8860
- NPI assigned
- Jul 13, 2006
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35042766 | OH | Primary |
Addresses
Primary practice location
247 S Burnett Rd
Suite 210
Springfield, OH 45505-2639
Mailing address
247 S Burnett Rd
Suite 210
Springfield, OH 45505-2639
Phone (937) 328-8850
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679598163 | Other | OH | NPI |
| 037-48-67 | Medicaid | OH | |
| 35-042766 | Other | OH | OHIO LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 35042766 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1679598163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "247 S BURNETT RD",
"address_2": "SUITE 210",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455052639",
"telephone_number": "937-328-8850",
"fax_number": "937-328-8860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "247 S BURNETT RD",
"address_2": "SUITE 210",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455052639",
"telephone_number": "937-328-8850",
"fax_number": "937-328-8860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNEISLEY",
"first_name": "ROBERT",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35042766",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1679598163",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "037-48-67",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO LICENSE",
"identifier": "35-042766",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.