NPIMap

Individual provider Active NPI

David L Tibbits, M.D.

  • Anesthesiology Physician
  • Kettering, OH
National Provider Identifier
1114907466
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
35073353 Issued in OH
Practice address
3533 Southern Blvd
Ste 3400
Kettering, OH 45429-1264
Phone
(937) 293-8228
Fax
(937) 293-8229
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 35073353 OH Primary

Addresses

Primary practice location

3533 Southern Blvd
Ste 3400
Kettering, OH 45429-1264

Mailing address

PO Box 713089
Columbus, OH 43271-3089
Phone (937) 293-8228

Other identifiers 1

IdentifierTypeStateIssuer
2189493MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040528000378 OH Practitioner - Anesthesiology 5092796656 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Ohio State University College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Anesthesia Associates, IncGroup PAC ID 0648170365, 54 clinicians

Practice addresses (Care Compare)

1625 Delco Park Dr
Dayton, OH 45420-1391
Phone (937) 535-2200

Hospital & facility affiliations

  • Wayne Hospital Hospital, Greenville, OH, CCN 361335
  • Trihealth Clinton Regional Hospital Hospital, Wilmington, OH, CCN 360175
  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
  • Upper Valley Medical Center Hospital, Troy, OH, CCN 360174

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sandusky Anesthesia LLC CurrentSince Apr 19, 2022 Accepting new patients
PHS Anesthesia Billing, LLC Anesthesiology CurrentSince May 15, 2025 Accepting new patients
Anesthesiology Services Network LTD Anesthesiology Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

600 N Pickaway St
Circleville, OH 43113
Phone (614) 352-6479

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

3130 N County Road 25A
Troy, OH 45373
Phone (937) 440-4000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GFEEDD/Endpoint/GFEEDD

Organizations & group practices 5

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1114907466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713089",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432713089",
            "telephone_number": "937-293-8228",
            "fax_number": "937-293-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 SOUTHERN BLVD",
            "address_2": "STE 3400",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291264",
            "telephone_number": "937-293-8228",
            "fax_number": "937-293-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBITS",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35073353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2189493",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.