Individual provider Active NPI

Ronald C Hetman

  • Podiatrist
  • Centerville, OH
National Provider Identifier
1760542955
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36001421H Issued in OH
Practice address
7301 Far Hills Avenue
Centerville, OH 45459-4415
Phone
(937) 433-0444
Fax
(937) 433-0405
NPI assigned
Dec 11, 2006
Last updated
May 14, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36001421H OH Primary

Addresses

Primary practice location

7301 Far Hills Avenue
Centerville, OH 45459-4415

Mailing address

7301 Far Hills Avenue
Centerville, OH 45459-4415
Phone (937) 433-0444

Other identifiers 1

IdentifierTypeStateIssuer
0217143MedicaidOH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1421OHMDRegistered Dietitian
36001421HOHMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Miami Valley Podiatry Associates LLC Podiatrist Past Accepting new patients

Organizations & group practices 2

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1760542955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 FAR HILLS AVENUE",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594415",
            "telephone_number": "937-433-0444",
            "fax_number": "937-433-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 FAR HILLS AVENUE",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594415",
            "telephone_number": "937-433-0444",
            "fax_number": "937-433-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETMAN",
        "first_name": "RONALD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36001421H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0217143",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.