Individual provider Active NPI

David Clay Lazenby, D.O.

  • Emergency Medicine Physician
  • Dayton, OH
National Provider Identifier
1992143531
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34.011583 Issued in OH
Practice address
405 W Grand Ave
Dayton, OH 45405-4720
Phone
(937) 723-3564
NPI assigned
Jun 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 34.011583 OH Primary

Addresses

Primary practice location

405 W Grand Ave
Dayton, OH 45405-4720

Mailing address

3131 Newmark Dr Ste 220
Miamisburg, OH 45342-5400
Phone (937) 436-4658

Other practice location 1

450 Washington Jackson Rd Ste F
Eaton, OH 45320-8699
Phone (937) 456-8376

Other practice location 2

8701 Old Troy Pike
Huber Heights, OH 45424-1066
Phone (937) 558-3338

Other practice location 3

1997 Miamisburg Centerville Rd
Centerville, OH 45459-3811
Phone (937) 401-6228

Other practice location 4

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone (937) 702-4500

Other practice location 5

100 Kettering Way
Franklin, OH 45005-1155
Phone (937) 458-4700

Other practice location 6

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342-7615
Phone (937) 384-8791

Other practice location 7

6147 State Route 122
Middletown, OH 45005-5201
Phone (513) 261-3410

Other practice location 8

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8166

Other practice location 9

600 W Main St
Troy, OH 45373-2928
Phone (937) 980-7010

Other practice location 10

1141 N Monroe Dr
Xenia, OH 45385-1619
Phone (937) 352-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, AZ2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150818006116 OH Practitioner - Emergency Medicine 4486884814 Reassigns benefits to 1 organization
I20190401002029 AZ Practitioner - Emergency Medicine 4486884814 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innova Emergency Medical Associates PCGroup PAC ID 2860633435, 69 clinicians

Practice addresses (Care Compare)

2200 E Show Low Lake Rd
Show Low, AZ 85901-7831
Phone (928) 537-4375

Hospital & facility affiliations

  • Savior Hospice Hospice, Phoenix, AZ, CCN 031651
  • Summit Healthcare Regional Medical Center Hospital, Show Low, AZ, CCN 030062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Innova Emergency Medical Associates PC Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Summit Healthcare Medical Associates CurrentSince Apr 1, 2019 Accepting new patients
Summit Healthcare Medical Associates CurrentSince Apr 1, 2019 Accepting new patients
Summit Healthcare Association Current Accepting new patients
Ohio Emergency Professionals Inc Emergency Medicine CurrentSince May 15, 2018 Accepting new patients
Emergency Medicine Specialists Inc Emergency Medicine Past Accepting new patients

Locations

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

630 Eaton Ave
Hamilton, OH 45013
Phone (513) 867-2000

Interoperability endpoints

  • Direct secure messaging: davidlazenby@shrmcshma.allscriptsdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1992143531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 NEWMARK DR STE 220",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453425400",
            "telephone_number": "937-436-4658",
            "fax_number": "888-654-7267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W GRAND AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454054720",
            "telephone_number": "937-723-3564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Washington Jackson Rd Ste F",
            "address_purpose": "LOCATION",
            "city": "Eaton",
            "state": "OH",
            "postal_code": "453208699",
            "country_code": "US",
            "telephone_number": "937-456-8376",
            "fax_number": "937-456-8377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8701 Old Troy Pike",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241066",
            "country_code": "US",
            "telephone_number": "937-558-3338",
            "fax_number": "937-558-3349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1997 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454593811",
            "country_code": "US",
            "telephone_number": "937-401-6228",
            "fax_number": "937-401-6447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Pentagon Blvd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454311705",
            "country_code": "US",
            "telephone_number": "937-702-4500",
            "fax_number": "937-702-4509",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Kettering Way",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "OH",
            "postal_code": "450051155",
            "country_code": "US",
            "telephone_number": "937-458-4700",
            "fax_number": "937-458-4737",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453427615",
            "country_code": "US",
            "telephone_number": "937-384-8791",
            "fax_number": "937-384-8729",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6147 State Route 122",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450055201",
            "country_code": "US",
            "telephone_number": "513-261-3410",
            "fax_number": "513-261-3419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-395-8166",
            "fax_number": "937-395-8347",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 W Main St",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "OH",
            "postal_code": "453732928",
            "country_code": "US",
            "telephone_number": "937-980-7010",
            "fax_number": "937-980-7019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1141 N Monroe Dr",
            "address_purpose": "LOCATION",
            "city": "Xenia",
            "state": "OH",
            "postal_code": "453851619",
            "country_code": "US",
            "telephone_number": "937-352-2500",
            "fax_number": "937-352-3501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAZENBY",
        "first_name": "DAVID",
        "middle_name": "CLAY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-05",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.011583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.