Active NPI
William O Light, MD
- Dermatology Physician
- Lima, OH
National Provider Identifier
1730101742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 35034390L
- Practice address
- 1005 Bellefontaine Ave
Ste 225
Lima, OH 45804-2896 - Phone
- (419) 228-8191
- Fax
- (419) 229-3490
- NPI assigned
- Jul 25, 2006
- 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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 35034390L | OH | Primary |
Addresses
Primary practice location
1005 Bellefontaine Ave
Ste 225
Lima, OH 45804-2896
Mailing address
1005 Bellefontaine Ave
Ste 225
Lima, OH 45804-2896
Phone (419) 228-8191
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0194463 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 35034390L | OH | MD | Dermatology 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 and National Provider Directory roles.
-
- 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": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730101742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 BELLEFONTAINE AVE",
"address_2": "STE 225",
"city": "LIMA",
"state": "OH",
"postal_code": "458042896",
"telephone_number": "419-228-8191",
"fax_number": "419-229-3490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 BELLEFONTAINE AVE",
"address_2": "STE 225",
"city": "LIMA",
"state": "OH",
"postal_code": "458042896",
"telephone_number": "419-228-8191",
"fax_number": "419-229-3490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIGHT",
"first_name": "WILLIAM",
"middle_name": "O",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "OH",
"license": "35034390L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0194463",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lima, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.