NPIMap

Individual provider Active NPI

Laurel Matthews, MD

  • Emergency Medicine Physician
  • Beavercreek, OH
National Provider Identifier
1801960471
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35063400 Issued in OH
Practice address
4471 Buckeye LN
Beavercreek, OH 45440-3197
Phone
(216) 225-4339
Fax
(440) 550-8825
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35063400 OH Primary
Surgical Critical Care Physician 2086S0102X 35063400 OH

Addresses

Primary practice location

4471 Buckeye LN
Beavercreek, OH 45440-3197

Mailing address

4471 Buckeye LN
Beavercreek, OH 45440-3197
Phone (216) 225-4339

Other identifiers 1

IdentifierTypeStateIssuer
0979544MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140915000784 TX Practitioner - Emergency Medicine 0840298766 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35063400OHMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Aug 10, 2015 Accepting new patients
US Health Dept of Health & Human Services CurrentSince Jul 29, 2014 Accepting new patients
U S Health Dept of Health & Human Services CurrentSince Jul 29, 2014 Accepting new patients
US Health Dept of Health & Human Services Current Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Aug 10, 2015 Accepting new patients
Genesis Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Bes of Ohio, LLC, Dba Medgroup Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Bes of Ohio, LLC Emergency Medicine Past Accepting new patients
Adena Medical Group LLC Past Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

Organizations & group practices 10

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1801960471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4471 BUCKEYE LN",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454403197",
            "telephone_number": "216-225-4339",
            "fax_number": "440-550-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4471 BUCKEYE LN",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454403197",
            "telephone_number": "216-225-4339",
            "fax_number": "440-550-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "LAUREL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35063400",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "OH",
            "license": "35063400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0979544",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.