Individual provider Active NPI

J Kevin Ahern, MD

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Springfield, OH
National Provider Identifier
1700830189
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
35.058701 Issued in OH
Practice address
100 Medical Center Dr
Springfield, OH 45504-2687
Phone
(937) 390-9665
Fax
(937) 215-6933
NPI assigned
May 20, 2006
Last updated
Sep 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35058701A OH
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 35.058701 OH Primary

Addresses

Primary practice location

100 Medical Center Dr
Springfield, OH 45504-2687

Mailing address

100 Medical Center Dr
Springfield, OH 45504-2687
Phone (937) 390-9665

Other identifiers 1

IdentifierTypeStateIssuer
2418119MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040602001202 OH Practitioner - Internal MedicinePractitioner - Family Practice 9133101389 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35058701AOHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Ohio, Professional Corporation Family Medicine CurrentSince Oct 1, 2015 Accepting new patients
Fairfield Hospitalists Inc Past Accepting new patients
Hospital Services Medical Group of Clark County Inc Past Accepting new patients
Pure Healthcare LLC Hospice and Palliative Medicine Past Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

6001 E Broad St
Columbus, OH 43213
Phone (614) 224-6420

5151 N Hamilton Rd
Gahanna, OH 43230
Phone (614) 337-1066

3000 Mack Rd
Hamilton, OH 45014
Phone (513) 870-7000

100 Medical Center Dr
Springfield, OH 45504
Phone (937) 523-1000

2615 E High St
Springfield, OH 45505
Phone (888) 861-3994

904 Scioto St
Urbana, OH 43078
Phone (937) 293-0136

Interoperability endpoints

  • Direct secure messaging: jahern3683@direct.bsmhealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1700830189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042687",
            "telephone_number": "937-390-9665",
            "fax_number": "937-215-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042687",
            "telephone_number": "937-390-9665",
            "fax_number": "937-215-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHERN",
        "first_name": "J",
        "middle_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35058701A",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "OH",
            "license": "35.058701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2418119",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.