NPIMap

Organization Active NPI

Alliance Physician Inc

Doing business as Sycamore Internal Medicine

  • Internal Medicine Physician
  • Miamisburg, OH
National Provider Identifier
1740562131
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ALLIANCE PHYSICIAN INC
Doing business as
Sycamore Internal Medicine
Practice address
4000 Miamisburg Centerville Rd
Suite 207
Miamisburg, OH 45342-3674
Phone
(937) 866-6655
Fax
(937) 866-6595
NPI assigned
Sep 13, 2011
Last updated
Sep 13, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
ALLIANCE PHYSICIAN INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Authorized official

Name
Daniel D Haibach
Title
Director Business Development
Phone
(937) 558-3222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

4000 Miamisburg Centerville Rd
Suite 207
Miamisburg, OH 45342-3674

Mailing address

2110 Leiter Rd
Miamisburg, OH 45342-3660
Phone (937) 384-4838

Other identifiers 1

IdentifierTypeStateIssuer
2712872MedicaidOH

Other names 1

  • Sycamore Internal Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northeast Family Practi77 organizations share this tax ID, including this one
Part of
Northeast Family Practi

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

4000 Miamisburg Centerville Rd
Ste 207
Miamisburg, OH 45342
Phone (937) 560-2011

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1740562131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 LEITER RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423660",
            "telephone_number": "937-384-4838",
            "fax_number": "937-384-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MIAMISBURG CENTERVILLE RD",
            "address_2": "SUITE 207",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423674",
            "telephone_number": "937-866-6655",
            "fax_number": "937-866-6595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE PHYSICIAN INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALLIANCE PHYSICIAN INC",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "HAIBACH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "937-558-3222"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2712872",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sycamore Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miamisburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.