NPIMap

Organization Active NPI

Bac Medical LLC

  • Family Medicine Physician
  • Dayton, OH
National Provider Identifier
1871484691
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BAC MEDICAL LLC
Practice address
5900 N Main St Ste 3
Dayton, OH 45415-3106
Phone
(937) 277-9371
Fax
(937) 277-7734
NPI assigned
Jul 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Authorized official

Name
Edward P Clack, DONPI 1659629053
Title
Owner / Physician
Phone
(937) 277-9371

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5900 N Main St Ste 3
Dayton, OH 45415-3106

Mailing address

5900 N Main St Ste 3
Dayton, OH 45415-3106
Phone (937) 277-9371

National Provider Directory

National Provider Directory

Locations

5900 N Main St
Ste 3
Dayton, OH 45415
Phone (937) 277-9371

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1752105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752105600000",
    "number": "1871484691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 N MAIN ST STE 3",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454153106",
            "telephone_number": "937-277-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 N MAIN ST STE 3",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454153106",
            "telephone_number": "937-277-9371",
            "fax_number": "937-277-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAC MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-10",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A",
        "authorized_official_last_name": "CLACK",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER / PHYSICIAN",
        "authorized_official_telephone_number": "937-277-9371",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.