Active NPI
Mvhe Inc
- Endocrinology, Diabetes & Metabolism Physician
- Dayton, OH
National Provider Identifier
1760681712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- Legal business name
- MVHE INC
- Doing business as
- Bull Family Diabetes Center
- Practice address
- 1222 S Patterson Blvd
Ste #210
Dayton, OH 45402-2684 - Phone
- (937) 208-9090
- Fax
- (937) 208-9075
- NPI assigned
- Jul 11, 2007
- Organization subpart
- Yes
- Parent organization
- MVHE INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kenneth Prunier
- Title
- President/Ceo
- Phone
- (937) 208-8213
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | |||
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | Primary |
Addresses
Primary practice location
1222 S Patterson Blvd
Ste #210
Dayton, OH 45402-2684
Mailing address
1222 S Patterson Blvd
Ste #210
Dayton, OH 45402-2684
Phone (937) 208-9090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2777482 | Medicaid | OH |
Other names 1
- Bull Family Diabetes Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031217000553 | OH | Part B Supplier - Clinic/Group Practice | 9537066584 |
Receives reassigned benefits from 777 practitioners 47 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Franklin, OH; Huber Heights, OH; Jamestown, OH; Kettering, OH; Lebanon, OH; Liberty Township, OH; Middletown, OH; Monroe, OH… |
Other NPIs on the same Medicare enrollment 47
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- Comprehensive Primary C
Locations
1222 S Patterson Blvd
Ste 210
Dayton, OH 45402
Phone (937) 208-9090
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184112000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1383696000000",
"number": "1760681712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1222 S PATTERSON BLVD",
"address_2": "STE #210",
"city": "DAYTON",
"state": "OH",
"postal_code": "454022684",
"telephone_number": "937-208-9090",
"fax_number": "937-208-9075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1222 S PATTERSON BLVD",
"address_2": "STE #210",
"city": "DAYTON",
"state": "OH",
"postal_code": "454022684",
"telephone_number": "937-208-9090",
"fax_number": "937-208-9075"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MVHE INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MVHE INC",
"enumeration_date": "2007-07-11",
"last_updated": "2013-11-06",
"status": "A",
"authorized_official_last_name": "PRUNIER",
"authorized_official_first_name": "KENNETH",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "937-208-8213"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RE0101X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2777482",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Bull Family Diabetes Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.