Individual provider Active NPI

Kurt B Avery, MD

  • Family Medicine Physician
  • Springboro, OH
National Provider Identifier
1811942006
Registry record updated Nov 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.064281 Issued in OH
Practice address
360 W Central Ave
Springboro, OH 45066-1106
Phone
(937) 208-7100
Fax
(937) 208-7125
NPI assigned
May 24, 2006
Last updated
Nov 13, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2013

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 35.064281 OH Primary

Addresses

Primary practice location

360 W Central Ave
Springboro, OH 45066-1106

Mailing address

360 W Central Ave
Springboro, OH 45066-1106
Phone (937) 208-7100

Other identifiers 1

IdentifierTypeStateIssuer
0978250MedicaidOH

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
I20100113000010 OH Practitioner - Family Practice 4486795432 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.064281OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe Inc CurrentSince Jul 8, 1994 Accepting new patients
Mvhe Inc Family Medicine CurrentSince Jul 8, 1994 Accepting new patients

Locations

722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

360 W Central Ave
Springboro, OH 45066
Phone (937) 208-7100

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1811942006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W CENTRAL AVE",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450661106",
            "telephone_number": "937-208-7100",
            "fax_number": "937-208-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W CENTRAL AVE",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450661106",
            "telephone_number": "937-208-7100",
            "fax_number": "937-208-7125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "KURT",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.064281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0978250",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springboro, OH

Sources for this page

Verify at the official NPI Registry.