Individual provider Active NPI

Egbe Egiebor, MD PHD

  • Student in an Organized Health Care Education/Training Program
  • Miamisburg, OH
National Provider Identifier
1831944081
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2115 Leiter Rd
Miamisburg, OH 45342-3600
Phone
(937) 384-6800
Fax
(937) 384-6938
NPI assigned
Apr 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2115 Leiter Rd
Miamisburg, OH 45342-3600

Mailing address

2641 Harrison LN
Beavercreek, OH 45431-5732
Phone (603) 264-2420

Other practice location 1

2145 N Fairfield Rd Ste 1002641
Beavercreek, OH 45431-2580
Phone (973) 558-3900

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
I20240702003954 OH Order and Referring Only - DermatologyPractitioner - DermatologyPractitioner - Hospitalist 1254875149

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: egbe.egiebor.1@415.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1831944081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2641 HARRISON LN",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454315732",
            "telephone_number": "603-264-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 LEITER RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423600",
            "telephone_number": "937-384-6800",
            "fax_number": "937-384-6938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2145 N Fairfield Rd Ste 1002641",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454312580",
            "country_code": "US",
            "telephone_number": "973-558-3900",
            "fax_number": "937-558-3999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGIEBOR",
        "first_name": "EGBE",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miamisburg, OH

Sources for this page

Verify at the official NPI Registry.