Northparke Internal Medicine LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

NORTHPARKE INTERNAL MEDICINE LLC

Practice address

211 Northparke Dr
Springfield, OH 45503

Phone

(937) 390-1700

Fax

(937) 390-2471

NPI assigned

Jul 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Keith A Boor, MD

Title

Physician Coowner

Phone

(937) 390-1700

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273449600000",
    "number": "1740206929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 NORTHPARKE DR",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "45503",
            "telephone_number": "937-390-1700",
            "fax_number": "937-390-2471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 NORTHPARKE DR",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "45503",
            "telephone_number": "937-390-1700",
            "fax_number": "937-390-2471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHPARKE INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2010-05-10",
        "status": "A",
        "authorized_official_last_name": "BOOR",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN COOWNER",
        "authorized_official_telephone_number": "937-390-1700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0154658",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.