NPIMap

Individual provider Active NPI

Lewis M Vichinsky, DPM

  • Podiatrist
  • Marysville, OH
National Provider Identifier
1881613974
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36001774V Issued in OH
Practice address
245 Stocksdale Dr
Marysville, OH 43040-1563
Phone
(937) 642-9936
Fax
(937) 642-5537
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36001774V OH Primary
Podiatrist 213E00000X DPMPDD14R LA

Addresses

Primary practice location

245 Stocksdale Dr
Marysville, OH 43040-1563

Mailing address

245 Stocksdale Dr
Marysville, OH 43040-1563
Phone (937) 642-9936

Other identifiers 2

IdentifierTypeStateIssuer
2457934MedicaidOH
P00092942OtherRR MCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DPMPDD14RLAMDPodiatrist
36001774VOHMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients
Gentle Footcare LLC Past Accepting new patients
Gentle Footcare LLC Podiatrist Past Accepting new patients

Organizations & group practices 3

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1881613974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 STOCKSDALE DR",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430401563",
            "telephone_number": "937-642-9936",
            "fax_number": "937-642-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 STOCKSDALE DR",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430401563",
            "telephone_number": "937-642-9936",
            "fax_number": "937-642-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICHINSKY",
        "first_name": "LEWIS",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36001774V",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "LA",
            "license": "DPMPDD14R",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2457934",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00092942",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.