Pai Participant 1 LLC
Organization Active NPI Geriatric Medicine (Internal Medicine) Physician · Chillicothe, OH
NPI 1093371312 · NPPES record last updated Aug 13, 2026
Key facts
- NPI
- 1093371312
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician 207RG0300X
- Legal business name
- PAI PARTICIPANT 1 LLC
- Practice address
- 60 Marietta Rd
Chillicothe, OH 45601-9433 - Phone
- (859) 291-4800
- NPI assigned
- May 13, 2019
- Organization subpart
- No
Authorized official
- Name
- Brittain Brantley
- Title
- Acting President
- Phone
- (302) 300-5138
Member of 1
Practitioners 530
-
Nicholas Adrian, NP-C
-
Benito A Alvarez, MD
-
Aric William Anderson, APRN-CNP
-
Julie Angel, APRN
-
Jennifer L Biddle, FNP
-
Eric Bletzinger, APRN
-
Amy Michelle Bolen, FNP-C
-
Abigail Elizabeth Burch, APRN
-
Jaymi Renee Butler, APRN
-
Amanda Carnes, APRN, FNP-BC
-
Jessica Lynne Coleman, D.O.
-
Jacqueline Croston, APRN-CNP
-
Stephanie F Dolan, APRN-CNP
-
Jessica Lynn Duke, APRN
-
Kimberly Dawn Dulaney, APRN
-
Michael Albert Dundr, M.D.
-
Mara Fine, CNP
-
Nikki Elaine Ford, MSN FNP-C
-
Melissa Fourmann, CNP
-
James Franz, DO
-
Caryn Gorby, CNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (15 enrollments) in MD, FL, KY, OH, TN, UT, MO, VA, VT, NH, ME, DC, MA, AL, DE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190611002122 | MD | Part B Supplier - Clinic/Group Practice | 8123351954 |
Receives reassigned benefits from 1 practitioner Practice locations: Brooklyn Park, MD; Baltimore, MD; Walkersville, MD; Salisbury, MD; Towson, MD |
| O20200323002065 | FL | Part B Supplier - Clinic/Group Practice | 8123351954 | Receives reassigned benefits from 14 practitioners |
| O20200331001591 | KY | Part B Supplier - Clinic/Group Practice | 8123351954 | Receives reassigned benefits from 27 practitioners |
| O20200402000312 | OH | Part B Supplier - Clinic/Group Practice | 8123351954 | Receives reassigned benefits from 174 practitioners |
| O20200403001264 | TN | Part B Supplier - Clinic/Group Practice | 8123351954 |
Receives reassigned benefits from 9 practitioners Practice locations: Byrdstown, TN; Westmoreland, TN; Tiptonville, TN; Tazewell, TN; Spring City, TN; Rockwood, TN; Ridgely, TN; Portland, TN… |
| O20200416000875 | UT | Part B Supplier - Clinic/Group Practice | 8123351954 |
Receives reassigned benefits from 5 practitioners Practice locations: South Salt Lake, UT; Salt Lake City, UT; South Jordan, UT; South Ogden, UT; Springville, UT; St George, UT; Taylorsville, UT; Washington Terrace, UT… |
| O20210503000979 | MO | Part B Supplier - Clinic/Group Practice | 8123351954 |
Receives reassigned benefits from 23 practitioners Practice locations: Saint Louis, MO; Saint Peters, MO; Town and Country, MO; Washington, MO; Webster Groves, MO; Weldon Spring, MO; Wildwood, MO; Maryland Heights, MO… |
| O20211208001934 | VA | Part B Supplier - Clinic/Group Practice | 8123351954 | Receives reassigned benefits from 227 practitioners |
| O20211213001706 | VT | Part B Supplier - Clinic/Group Practice | 8123351954 | Practice locations: Barre, VT; St Johnsbury, VT; Springfield, VT; Saint Albans, VT; Newport, VT; Bennington, VT |
| O20220613000044 | NH | Part B Supplier - Clinic/Group Practice | 8123351954 |
Receives reassigned benefits from 9 practitioners Practice locations: Manchester, NH; Milford, NH; Meredith, NH; Nashua, NH; Newport, NH; North Conway, NH; Peterborough, NH; Portsmouth, NH… |
| O20220719000230 | ME | Part B Supplier - Clinic/Group Practice | 8123351954 |
Receives reassigned benefits from 2 practitioners Practice locations: Hartland, ME; Kennebunk, ME; Kittery, ME; Lewiston, ME; Madison, ME; Pittsfield, ME; Portland, ME; Scarborough, ME… |
| O20221103000005 | DC | Part B Supplier - Clinic/Group Practice | 8123351954 |
Receives reassigned benefits from 64 practitioners Practice locations: Lanham, MD |
| O20230106000629 | MA | Part B Supplier - Clinic/Group Practice | 8123351954 | Receives reassigned benefits from 6 practitioners |
| O20230801002991 | AL | Part B Supplier - Clinic/Group Practice | 8123351954 |
Receives reassigned benefits from 1 practitioner Practice locations: Birmingham, AL |
| O20260102002839 | DE | Part B Supplier - Clinic/Group Practice | 8123351954 |
Receives reassigned benefits from 2 practitioners Practice locations: Wilmington, DE |
National Provider Directory
Locations (25 of 59)
225 Amity Rd
Woodbridge, CT 06525
Phone (203) 387-0076
4042 Park Oaks Blvd
Tampa, FL 33610
Phone (813) 635-9500
601 N Boeke Rd
Evansville, IN 47711
Phone (812) 476-4912
950 Cross Ave
Madison, IN 47250
Phone (812) 273-4640
201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229
853 Lexington Rd
Harrodsburg, KY 40330
Phone (859) 374-7791
2770 Palumbo Dr
Lexington, KY 40509
Phone (859) 263-2410
420 E Grundy Ave
Springfield, KY 40069
Phone (859) 336-7771
804 Pleasant St
Brockton, MA 02301
Phone (508) 583-3000
44 Summer St
Danvers, MA 01923
Phone (978) 774-6955
17 Chipman Way
Kingston, MA 02364
Phone (781) 336-5107
476 Varnum Ave
Lowell, MA 01854
Phone (978) 458-3388
300 Winthrop St
Medford, MA 02155
Phone (781) 369-4400
1801 Turnpike St
North Andover, MA 01845
Phone (978) 454-8086
309 Driftway
Scituate, MA 02066
Phone (781) 545-1370
5060 Washington St
West Roxbury, MA 02132
Phone (617) 323-5440
4 School House Dr
Falmouth, ME 04105
Phone (207) 481-4428
174 Main St
Madison, ME 04950
Phone (207) 326-4344
1003 S Cedar St
Belton, MO 64012
Phone (816) 331-0781
930 NE Duncan Rd
Blue Springs, MO 64014
Phone (816) 229-6677
2500 S Old Highway 94
Ste 94
Saint Charles, MO 63303
Phone (636) 946-0761
11500 Olive Blvd
Saint Louis, MO 63141
3801 McClay Rd
Saint Peters, MO 63376
Phone (636) 244-3323
136A Arch St
Keene, NH 03431
Phone (603) 357-3902
501 Pinecrest Dr
Beverly, OH 45715
Phone (740) 984-4262
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician |
207RG0300X | Yes | ||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
60 Marietta Rd
Chillicothe, OH 45601-9433
Mailing address
PO Box 639676
Cincinnati, OH 45263-9676
Phone (859) 291-4800
Other practice location 1
505 Couch Ave
Kirkwood, MO 63122-5577
Phone (314) 909-6010
Other practice location 2
13755 Golf Club Pkwy
Fort Myers, FL 33919-5146
Phone (239) 482-2848
Other practice location 3
7700 York Rd
Towson, MD 21204-7513
Phone (410) 821-5500
Other providers in Chillicothe, OH
- Beth Ann Pack
- Courtney Pack
- Autumn Page
- Kaylee Page
- Pamela E Page
- Anne Pairan
- Kathleen Joann Pallotta
- Hannah Palme
- Abbey Lynne Palmer
- Lindsey Palmer
All providers in Chillicothe, OH · Geriatric Medicine (Internal Medicine) Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.