NPIMap

Organization Active NPI

Lakota Medical, LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Hamilton, OH
National Provider Identifier
1730192097
Registry record updated Aug 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
34-004296 Issued in OH
Legal business name
LAKOTA MEDICAL, LLC
Practice address
1755 S Erie Hwy Ste a
Hamilton, OH 45011-4145
Phone
(513) 893-8000
Fax
(513) 893-8200
NPI assigned
Aug 15, 2006
Last updated
Aug 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2009

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

Authorized official

Name
William D Miles, D.O.NPI 1326062290
Title
President
Phone
(513) 893-8000

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 34-004296 OH Primary

Addresses

Primary practice location

1755 S Erie Hwy Ste a
Hamilton, OH 45011-4145

Mailing address

2466 Tennyson Dr
Bellbrook, OH 45305-1744
Phone (513) 893-8000

Other identifiers 1

IdentifierTypeStateIssuer
000000364512OtherOHANTHEM BC BS

National Provider Directory

National Provider Directory

Locations

3145 Hamilton Mason Rd
Ste 201
Fairfield Township, OH 45011
Phone (513) 454-2277

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249862400000",
    "number": "1730192097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2466 TENNYSON DR",
            "city": "BELLBROOK",
            "state": "OH",
            "postal_code": "453051744",
            "telephone_number": "513-893-8000",
            "fax_number": "937-848-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 S ERIE HWY STE A",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450114145",
            "telephone_number": "513-893-8000",
            "fax_number": "513-893-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKOTA MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2009-08-10",
        "status": "A",
        "authorized_official_last_name": "MILES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-893-8000",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "OH",
            "license": "34-004296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "000000364512",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.