Individual provider Active NPI

David Brewer Stultz, MD

  • Cardiovascular Disease Physician
  • Kettering, OH
National Provider Identifier
1104887280
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35081707 Issued in OH
Practice address
1380 E Stroop Rd
Kettering, OH 45429-4926
Phone
(937) 293-3486
Fax
(937) 293-3605
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35081707 OH Primary

Addresses

Primary practice location

1380 E Stroop Rd
Kettering, OH 45429-4926

Mailing address

1380 E Stroop Rd
Kettering, OH 45429-4926
Phone (937) 293-3486

Other identifiers 1

IdentifierTypeStateIssuer
2629365MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/
Direct Messaging Address dstultz204913@direct.ketteringhealth.org

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
I20060308000840 OH Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2062429525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Cincinnati College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

1141 N Monroe Dr
Xenia, OH 45385-1619
Phone (937) 490-2270

1380 E Stroop Rd
Kettering, OH 45429-4926
Phone (937) 293-3486

3533 Southern Blvd
Suite 2200
Kettering, OH 45429-1264
Phone (937) 228-4126

3535 Pentagon Blvd
Beavercreek, OH 45431-1705

3535 Pentagon Park Blvd
Suite 400
Dayton, OH 45431-1705
Phone (937) 490-2264

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8646

405 W Grand Ave
Dayton, OH 45405-7538
Phone 93722368376837

4160 Little York Rd
Suite 20
Dayton, OH 45414-5803
Phone (937) 454-9527

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

600 W Main St
Troy, OH 45373-3384

7677 Yankee St
Suite 140
Dayton, OH 45459-3475
Phone (866) 224-9472

Hospital & facility affiliations

  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239
  • Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
  • Kettering Health Troy Hospital, Troy, OH, CCN 360368

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35081707OHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc Cardiovascular Disease CurrentSince Dec 29, 2022 Accepting new patients
Kettering Medical Center Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3535 Pentagon Blvd
Ste 320
Beavercreek, OH 45431
Phone (937) 490-2270

1023 S Main St
Ste 200
Centerville, OH 45458
Phone (937) 429-7350

8057 Washington Village Dr
Dayton, OH 45458
Phone (937) 312-9890

1380 E Stroop Rd
Bldg 2
Kettering, OH 45429

1380 E Stroop Rd
Kettering, OH 45429
Phone (937) 293-3486

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

3533 Southern Blvd
Ste 2100
Kettering, OH 45429
Phone (937) 293-3486

2110 Leiter Rd
Miamisburg, OH 45342
Phone (937) 384-4838

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

38 N Breiel Blvd
Middletown, OH 45042
Phone (513) 422-5338

1079 Fairington Dr
Ste 100
Sidney, OH 45365
Phone (937) 293-3486

825 N Main St
Ste 130
Springboro, OH 45066
Phone (937) 401-7583

70 Weller Dr
Tipp City, OH 45371
Phone (937) 298-4417

7677 Yankee St
Ste 140
Washington Township, OH 45459
Phone (866) 224-9472

Organizations & group practices 3

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 5

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1104887280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 E STROOP RD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454294926",
            "telephone_number": "937-293-3486",
            "fax_number": "937-293-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 E STROOP RD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454294926",
            "telephone_number": "937-293-3486",
            "fax_number": "937-293-3605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STULTZ",
        "first_name": "DAVID",
        "middle_name": "BREWER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35081707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2629365",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1380 E Stroop Rd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454294926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dstultz204913@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "1380 E Stroop Rd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454294926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.