Individual provider Active NPI

Mary Elizabeth Krebs, M.D.

  • Family Medicine Physician
  • Lebanon, OH
National Provider Identifier
1801912308
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
87167 Issued in OH
Practice address
1231 Columbus Ave Unit A1
Lebanon, OH 45036-8196
Phone
(513) 696-4495
Fax
(513) 228-1236
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 87167 OH Primary

Addresses

Primary practice location

1231 Columbus Ave Unit A1
Lebanon, OH 45036-8196

Mailing address

424 Wards Corner Rd Ste 200
Loveland, OH 45140-6966
Phone (513) 707-4041

Other identifiers 1

IdentifierTypeStateIssuer
3038439MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070803000321 OH Practitioner - Family Practice 2668563784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Five Rivers Health CentersGroup PAC ID 9335300904, 45 clinicians

Practice addresses (Care Compare)

721 Miami Chapel Rd
Dayton, OH 45417-4650
Phone (937) 281-6800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
87167OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Five Rivers Health Centers Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Five Rivers Health Centers Family Medicine Current Accepting new patients
Five Rivers Health Centers Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Family Practice Associates of Southwest Ohio Inc Family Medicine PastSince Jan 1, 2009 Accepting new patients

Locations

2261 Philadelphia Dr
Dayton, OH 45406
Phone (937) 281-6800

721 Miami Chapel Rd
Dayton, OH 45417
Phone (937) 281-5970

Interoperability endpoints

  • Direct secure messaging: marykrebs@fpaswo.allscriptsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1801912308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 WARDS CORNER RD STE 200",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451406966",
            "telephone_number": "513-707-4041",
            "fax_number": "513-576-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 COLUMBUS AVE UNIT A1",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450368196",
            "telephone_number": "513-696-4495",
            "fax_number": "513-228-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREBS",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "87167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3038439",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, OH

Sources for this page

Verify at the official NPI Registry.