Active NPI
Edward J Kinkopf, D.O.
- Family Medicine Physician
- Centerville, OH
National Provider Identifier
1932101151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34002998K
- Practice address
- 1989 Miamisburg Centerville Rd
Ste 301
Centerville, OH 45459-3858 - Phone
- (937) 434-7353
- Fax
- (937) 438-6569
- NPI assigned
- Jun 1, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34002998K | OH | Primary |
Addresses
Primary practice location
1989 Miamisburg Centerville Rd
Ste 301
Centerville, OH 45459-3858
Mailing address
2912 Springboro W
Ste 201
Dayton, OH 45439-1674
Phone (937) 434-7353
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OC03635 | Other | OH | NATIONWIDE HEALTH PLAN |
| 0480224 | Medicaid | OH | |
| D0299805 | Other | OH | HUMANA/CHOICECARE |
| 000000227873 | Other | OH | UNICARE |
| 080191713 | Other | OH | RAILROAD MEDICARE |
| 421534506074 | Other | OH | CARESOURCE |
| 000000227873 | Other | OH | ANTHEM |
| 0120251 | Other | OH | UNITED HEALTHCARE |
| 2220377 | Other | OH | AETNA |
| 34002998 | Other | OH | MEDICAL LICENSE |
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34002998K | OH | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367193600000",
"number": "1932101151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2912 SPRINGBORO W",
"address_2": "STE 201",
"city": "DAYTON",
"state": "OH",
"postal_code": "454391674",
"telephone_number": "937-434-7353",
"fax_number": "937-438-6569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1989 MIAMISBURG CENTERVILLE RD",
"address_2": "STE 301",
"city": "CENTERVILLE",
"state": "OH",
"postal_code": "454593858",
"telephone_number": "937-434-7353",
"fax_number": "937-438-6569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINKOPF",
"first_name": "EDWARD",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-01",
"last_updated": "2013-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "34002998K",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONWIDE HEALTH PLAN",
"identifier": "OC03635",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0480224",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA/CHOICECARE",
"identifier": "D0299805",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNICARE",
"identifier": "000000227873",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080191713",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCE",
"identifier": "421534506074",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000227873",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0120251",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2220377",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "34002998",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Centerville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.