Individual provider Active NPI

Traesa A. Brown, MD

  • Family Medicine Physician
  • Vandalia, OH
National Provider Identifier
1053407973
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35148567 Issued in OH
Practice address
400 Corporate Center Dr
Vandalia, OH 45377-1164
Phone
(937) 454-5296
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32486 SC
Family Medicine Physician 207Q00000X 35148567 OH Primary

Addresses

Primary practice location

400 Corporate Center Dr
Vandalia, OH 45377-1164

Mailing address

2912 Springboro W Ste 201
Moraine, OH 45439-1674
Phone (937) 297-8999

Other practice location 1

312 S McQueen St
Florence, SC 29501-4723
Phone (843) 799-2978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250224001719 OH Practitioner - Family Practice 1456358456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical GroupGroup PAC ID 2860386349, 29 clinicians

Practice addresses (Care Compare)

400 Corporate Ctr Dr
Vandalia, OH 45377-1164
Phone (937) 454-5296

Hospital & facility affiliations

  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35148567OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Group Family Medicine Current Accepting new patients
Providence Medical Group, Inc. CurrentSince Dec 5, 2024 Accepting new patients
Osh-Oh Physicians Group PC Family Medicine CurrentSince Jul 23, 2023 Accepting new patients
Comprehensive Rehab Consultants PLLC PastSince Jul 23, 2023 Accepting new patients

Locations

4271 W 3rd St
Dayton, OH 45417
Phone (937) 348-7001

2912 Springboro W
Ste 201
Moraine, OH 45439
Phone (937) 297-8996

400 Corporate Center Dr
Vandalia, OH 45377
Phone (937) 410-3838

Interoperability endpoints

  • Direct secure messaging: tbrown@sfm.direct.myupdox.com
  • Direct secure messaging: traesa.brown.1@237.direct.athenahealth.com

Organizations & group practices 4

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 1

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1053407973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2912 SPRINGBORO W STE 201",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391674",
            "telephone_number": "937-297-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CORPORATE CENTER DR",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453771164",
            "telephone_number": "937-454-5296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "312 S McQueen St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "SC",
            "postal_code": "295014723",
            "country_code": "US",
            "telephone_number": "843-799-2978",
            "fax_number": "843-799-2980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TRAESA",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "32486",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35148567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vandalia, OH

Sources for this page

Verify at the official NPI Registry.