Active NPI
Fleagle Internal Medicine LLC
- Internal Medicine Physician
- Dayton, OH
National Provider Identifier
1699967513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- FLEAGLE INTERNAL MEDICINE LLC
- Doing business as
- KURT FLEAGLE M.D.
- Practice address
- 5250 Far Hills Ave
Suite 210
Dayton, OH 45429 - Phone
- (937) 434-4775
- Fax
- (833) 450-5129
- NPI assigned
- Aug 14, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kurt Andrew Fleagle, MD
- Title
- Physician
- Phone
- (937) 434-4775
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | |||
| Internal Medicine Physician | 207R00000X | OH | Primary |
Addresses
Primary practice location
5250 Far Hills Ave
Suite 210
Dayton, OH 45429
Mailing address
5250 Far Hills Ave
Suite 210
Dayton, OH 45429
Phone (937) 434-4775
Other names 1
- KURT FLEAGLE M.D.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D1034512 | Fleagle Internal Medicine LLC | Certificate of waiver | Dec 5, 2026 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Kettering, OH
- NPI 1750382602
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187049600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1714867200000",
"number": "1699967513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5250 FAR HILLS AVE",
"address_2": "SUITE 210",
"city": "DAYTON",
"state": "OH",
"postal_code": "45429",
"telephone_number": "937-434-4775",
"fax_number": "937-434-4779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5250 FAR HILLS AVE",
"address_2": "SUITE 210",
"city": "DAYTON",
"state": "OH",
"postal_code": "45429",
"telephone_number": "937-434-4775",
"fax_number": "833-450-5129"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FLEAGLE INTERNAL MEDICINE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-14",
"last_updated": "2024-05-05",
"certification_date": "2024-05-05",
"status": "A",
"authorized_official_last_name": "FLEAGLE",
"authorized_official_first_name": "KURT",
"authorized_official_middle_name": "ANDREW",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "937-434-4775",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "OH",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "KURT FLEAGLE M.D.",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.