NPIMap

Organization Active NPI

Knox Community Hospital

  • Anesthesiology Physician
  • Mount Vernon, OH
National Provider Identifier
1679626287
Registry record updated Apr 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
35.052379 Issued in OH
Legal business name
KNOX COMMUNITY HOSPITAL
Practice address
1330 Coshocton Ave
Mount Vernon, OH 43050-1440
Phone
(740) 393-9000
NPI assigned
Jan 18, 2007
Last updated
Apr 20, 2010By the provider in NPPES
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
Mr. Michael Ambrosiani
Title
Cfo
Phone
(740) 393-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 35.052379 OH Primary

Addresses

Primary practice location

1330 Coshocton Ave
Mount Vernon, OH 43050-1440

Mailing address

1330 Coshocton Ave
Mount Vernon, OH 43050-1440
Phone (740) 393-6585

Other identifiers 1

IdentifierTypeStateIssuer
2506121MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040722001173 OH Part B Supplier - Clinic/Group Practice 1153301833 Receives reassigned benefits from 202 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mount Vernon, OH; Mt Vernon, OH; Ontario, OH; Centerburg, OH; Galion, OH; Bucyrus, OH; Danville, OH; Fredericktown, OH…

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
David McCann MD13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 91

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.

View all 91

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271721600000",
    "number": "1679626287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 COSHOCTON AVE",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430501440",
            "telephone_number": "740-393-6585",
            "fax_number": "740-392-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 COSHOCTON AVE",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430501440",
            "telephone_number": "740-393-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOX COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2010-04-20",
        "status": "A",
        "authorized_official_last_name": "AMBROSIANI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "740-393-9000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35.052379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2506121",
            "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 Apr 20, 2010; 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.