Beth E Duvall, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35.067958 Issued in OH

Practice address

105 Sugar Camp Cir
Suite 140
Oakwood, OH 45409-1962

Phone

(937) 395-3622

Fax

(937) 395-3646

NPI assigned

Dec 28, 2005

Last updated

Jan 22, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 27, 2015 through Jan 27, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Executive Medical Centers of Ohio

  • Internal Medicine Physician
  • Oakwood, OH
  • NPI 1275129272
  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1891772216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SUGAR CAMP CIR",
            "address_2": "SUITE 140",
            "city": "OAKWOOD",
            "state": "OH",
            "postal_code": "454091962",
            "telephone_number": "937-395-3622",
            "fax_number": "937-395-3646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SUGAR CAMP CIR",
            "address_2": "SUITE 140",
            "city": "OAKWOOD",
            "state": "OH",
            "postal_code": "454091962",
            "telephone_number": "937-395-3622",
            "fax_number": "937-395-3646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUVALL",
        "first_name": "BETH",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-28",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.067958",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.067958",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0227025",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Comprehensive Geriatric Care, LLC
• Compunet Clinical Laboratories, LLC
• Bryn Cortez
• Mitzi Davis, LMT
• Ronda Doster, MS LPC
• Executive Medical Centers of Ohio
• Jennifer Fowler, OD
• Kathleen Fraser, LISW-S
• Brenna Marie Gingrich, NP
• Barry L. Gridley, O.D.

• Internal Medicine Physician in Oakwood, OH
• Providers in Oakwood, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.