NPIMap

Individual provider Active NPI

William S Eddy, DO

  • Family Medicine Physician
  • Niles, OH
National Provider Identifier
1992788509
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3699 Issued in OH
Practice address
929 Robbins Ave
Niles, OH 44446-2441
Phone
(330) 652-5512
Fax
(330) 652-5122
NPI assigned
Nov 29, 2005
Last updated
Nov 17, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3699 OH Primary

Addresses

Primary practice location

929 Robbins Ave
Niles, OH 44446-2441

Mailing address

929 Robbins Ave
Niles, OH 44446-2441
Phone (330) 652-5512

Other identifiers 1

IdentifierTypeStateIssuer
0575515MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100223000418 OH Practitioner - Family PracticePractitioner - General Practice 3678617024 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
Ohio University, College of Osteopathic Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Youngstown, LLCGroup PAC ID 9234318270, 116 clinicians
Novacare Rehabilitation of Ohio IncGroup PAC ID 0345159315, shared by 5 NPIs, 76 clinicians

Practice addresses (Care Compare)

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 480-2182

656 Youngstown Warren Rd
Niles, OH 44446-4356
Phone (330) 505-1362

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3699OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown, LLC Family Medicine Current Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown LLC CurrentSince Jul 17, 2015 Accepting new patients
City of Niles PastSince Nov 2, 2011 Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

929 Robbins Ave
Niles, OH 44446
Phone (330) 652-5512

1950 Niles Cortland Rd NE
Ste 1
Warren, OH 44484
Phone (330) 306-0395

667 Eastland Ave SE
Warren, OH 44484
Phone (330) 841-2378

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929

Interoperability endpoints

  • Direct secure messaging: weddy34684@direct.bsmhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1992788509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 ROBBINS AVE",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444462441",
            "telephone_number": "330-652-5512",
            "fax_number": "330-652-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 ROBBINS AVE",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444462441",
            "telephone_number": "330-652-5512",
            "fax_number": "330-652-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDDY",
        "first_name": "WILLIAM",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "3699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0575515",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, OH

Sources for this page

Verify at the official NPI Registry.