Sycamore Internal Medicine and Women'S Wellness Center Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35-07-8961F Issued in OH

Legal business name

SYCAMORE INTERNAL MEDICINE AND WOMEN'S WELLNESS CENTER INC

Practice address

4000 Miamisburg Centerville Rd
Suite 207
Miamisburg, OH 45342-3758

Phone

(937) 866-6655

Fax

(937) 866-6595

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Vida Farhangi, MD

Title

President

Phone

(937) 866-6655

Specialties & licenses 2

Addresses

Other identifiers 15

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anna Elizabeth Hatic, DO

  • Internal Medicine Physician
  • Greenville, OH
  • NPI 1770795973

  Internal Medicine

  NPD (past)
• Muna Jneidi, MD

  • Internal Medicine Physician
  • Centerville, OH
  • NPI 1851374615

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225670400000",
    "number": "1891837076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453430270",
            "telephone_number": "937-866-6655",
            "fax_number": "937-866-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MIAMISBURG CENTERVILLE RD",
            "address_2": "SUITE 207",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423758",
            "telephone_number": "937-866-6655",
            "fax_number": "937-866-6595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYCAMORE INTERNAL MEDICINE AND WOMEN'S WELLNESS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2008-11-03",
        "status": "A",
        "authorized_official_last_name": "FARHANGI",
        "authorized_official_first_name": "VIDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-866-6655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-07-8961F",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "OH",
            "license": "35.092005",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0565421",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2232873",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "D-78961",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000578348",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL OF OHIO",
            "identifier": "274966422004",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6199428002",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2678666",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "76-00115",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000233015",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RENDERING PROVIDER NPI",
            "identifier": "1851390983",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2472827",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7028685",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000233015",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB6813",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RENDERING PROVIDER",
            "identifier": "1851374615",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Michelle Susong
• Lisa Sutton
• Amanda Paige Swafford, MSN, APRN, PMHNP-BC
• Krisalyn Swayze Massaro, MD
• Jennifer Lynn Sweat-Burdette, M.D.
• Sycamore Primary Care Group
• Sycamorespring Health Care and Rehabilitation LLC
• Kara Danielle Szlag, MD
• Lori Taylor
• Douglas W Teller, MD

• All providers in Miamisburg, OH
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; 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.