John K Loudermilk Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

30023348 Issued in OH

Legal business name

JOHN K LOUDERMILK INC.

Practice address

260 W. Locust St.
Wilmington, OH 45177

Phone

(937) 382-0951

Fax

(937) 382-0953

NPI assigned

May 13, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Gayle M Lakes

Title

Office Manager

Phone

(937) 382-0951

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1305244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305244800000",
    "number": "1952693590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 W. LOCUST ST.",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "45177",
            "telephone_number": "937-382-0951",
            "fax_number": "937-382-0953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 W. LOCUST ST.",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "45177",
            "telephone_number": "937-382-0951",
            "fax_number": "937-382-0953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN K LOUDERMILK INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-13",
        "last_updated": "2011-05-13",
        "status": "A",
        "authorized_official_last_name": "LAKES",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "937-382-0951",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "30023348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3100361",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Wilmington, OH
• Providers in Wilmington, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2011; 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.