MAPLE LEAF FAMILY AND SPORTS MEDICINE, LLC (NPI# 1447328067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447328067 |
| Entity Type | Organization |
| Organization Name | MAPLE LEAF FAMILY AND SPORTS MEDICINE, LLC |
| Practice Address |
2211 Timber Trail Bellefontaine OH 43311 |
| Practice Telephone | 9375923808 |
| Practice Fax Number | 9375938404 |
| Mailing Telephone | 9375923808 |
| Mailing Fax Number | 9375938404 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. BOYD C HODDINOTT (PARTNER) |
| Authorized Official Telephone | 9375923808 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2225827 | 05 |
| Street Address |
2211 TIMBER TRAIL |
| City | BELLEFONTAINE |
| State | OH |
| Zip Code | 43311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760082515 | Liza Hensley | Pharmacist | 2281 S. Main Street, Bellefontaine, OH 43311 | 2020-10-30 |
| 1285273367 | Mona Kaye Garrison | Family Medicine | 1860 S Main St, Bellefontaine, OH 43311 | 2020-01-06 |
| 1316429012 | Hana Elizabeth Fischesser | Speech-Language Pathologist | 205 Palmer Street, Bellefontaine, OH 43311 | 2018-08-30 |
| 1063934719 | Sophia Do Vang | Physician Assistant | 1860 S Main Street, Bellefontaine, OH 43311 | 2017-07-14 |
| 1164978441 | Jennifer Gaver | Specialist | 921 Rush Avenue, Bellefontaine, OH 43311 | 2016-08-28 |
| 1598186561 | Candice Nanette Stevens | Registered Nurse | 208 Blair Ave, Bellefontaine, OH 43311 | 2013-12-18 |
| 1225395361 | Nicholas J Peters | Orthopaedic Surgery | 1134 N Main St Ste 2500, Bellefontaine, OH 43311 | 2012-04-13 |
| 1679868889 | Melissa Rae Lallo | Physical Therapist | 711 Rush Avenue, Bvellefontaine, OH 43311 | 2011-06-15 |
| 1912146572 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 141 Richard Avenue, Bellefontaine, OH 43311 | 2009-02-05 |
| 1710126370 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 329 East Spring Avenue, Bellefontaine, OH 43311 | 2009-02-05 |
| Find all providers in zip 43311 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285273367 | Mona Kaye Garrison | Family Medicine | 1860 S Main St, Bellefontaine, OH 43311 | 2020-01-06 |
| 1891250643 | Family Urgent Care LLC | Family Medicine | 1860 South Main Street, Bellefontaine, OH 43311-9997 | 2019-02-06 |
| 1891997169 | Mary Rutan Hospital | Family Medicine | 21 Hunter Pl, Suite C, Bellefontaine, OH 43311-3002 | 2007-05-31 |
| 1104902824 | Michael Richey Gleason | Family Medicine | 212 E Columbus Ave Ste 3, Bellefontaine, OH 43311-2023 | 2006-10-27 |
| 1083795850 | Mabbu Gajapathy Shivaprasad | Family Medicine | Logan Family Medical Center LLC, 2210 Timber Trail, Bellefontaine, OH 43311 | 2006-10-18 |
| 1114947454 | Thomas E. Darrah | Family Medicine | 130 N Detroit St, Bellefontaine, OH 43311-1464 | 2006-07-20 |
| 1558302448 | Ryan D. Kauffman | Family Medicine | 208 W Columbus Ave, Bellefontaine, OH 43311-1434 | 2006-06-09 |
| 1003807231 | Deron L Horman | Family Medicine | 1134 N Main St Ste 1100, Bellefontaine, OH 43311 | 2005-11-05 |
| 1295723419 | Steven Paul Hooley | Family Medicine | 705 N Madriver St, Bellefontaine, OH 43311-2218 | 2005-10-11 |
| 1831654516 | Family Urgent Care LLC | Family Medicine | 1860 South Main Street, Bellefontaine, OH 43311-9997 | 2019-02-06 |
| Find all providers in BELLEFONTAINE | ||||
| City | BELLEFONTAINE |
| Zip Code | 43311 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.