NPIMap

Organization Active NPI

South Community

  • Community/Behavioral Health Agency
  • Kettering, OH
National Provider Identifier
1003211061
Registry record updated Nov 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SOUTH COMMUNITY
Practice address
2745 S Smithville Rd
Kettering, OH 45420-2668
Phone
(937) 258-4246
NPI assigned
Nov 1, 2014
Last updated
Nov 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2014

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

Authorized official

Name
Melissa Buck, MS, PCC-SNPI 1205180908
Title
Yph Program Manager
Phone
(937) 258-4246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2745 S Smithville Rd
Kettering, OH 45420-2668

Mailing address

8130 Towson Blvd
Miamisburg, OH 45342-6120

National Provider Directory

National Provider Directory
Tax ID family
South Community3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2745 S Smithville Rd
Kettering, OH 45420
Phone (937) 252-0100

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1414800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414800000000",
    "number": "1003211061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8130 TOWSON BLVD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453426120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 S SMITHVILLE RD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454202668",
            "telephone_number": "937-258-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-01",
        "last_updated": "2014-11-01",
        "status": "A",
        "authorized_official_last_name": "BUCK",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "YPH PROGRAM MANAGER",
        "authorized_official_telephone_number": "937-258-4246",
        "authorized_official_credential": "MS, PCC-S"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2014; 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.