Individual provider Active NPI

Maxwell Benjamin Couch, PA-C

  • Physician Assistant
  • Westerville, OH
National Provider Identifier
1184264376
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
444 N Cleveland Ave Ste 130
Westerville, OH 43082-8388
Phone
(614) 839-1118
NPI assigned
Jan 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

444 N Cleveland Ave Ste 130
Westerville, OH 43082-8388

Mailing address

3131 Newmark Dr Ste 220
Miamisburg, OH 45342-5400
Phone (937) 436-4658

Other practice location 1

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8166

Other practice location 2

1 Kettering Way
Piqua, OH 45356-4146
Phone (937) 916-2625

Other practice location 3

600 W Main St
Troy, OH 45373-3384
Phone (937) 980-7010

Other practice location 4

1997 Miamisburg Centerville Rd
Centerville, OH 45459-3811
Phone (937) 401-6228

Other practice location 5

405 W Grand Ave
Dayton, OH 45405-7538
Phone (937) 723-3211

Other practice location 6

450F Washington Jackson Rd
Eaton, OH 45320-8699
Phone (937) 456-8376

Other practice location 7

6147 State Route 122
Middletown, OH 45005-5201
Phone (513) 261-3410

Other practice location 8

100 Kettering Way
Franklin, OH 45005-1155
Phone (937) 458-4700

Other practice location 9

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone (937) 702-4500

Other practice location 10

1141 N Monroe Dr
Xenia, OH 45385-1619
Phone (937) 352-2500

Other practice location 11

8701 Old Troy Pike
Huber Heights, OH 45424-1066
Phone (937) 558-3338

Other practice location 12

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342-7615
Phone (937) 384-8791

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200321000180 OH Practitioner - Physician Assistant 5294163432 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc CurrentSince Sep 15, 2020 Accepting new patients
Emergency Medicine Specialists, Inc Physician Assistant CurrentSince Sep 27, 2021 Accepting new patients
Premier Health Specialists Inc CurrentSince Sep 15, 2020 Accepting new patients
Emergency Medicine Specialists, Inc. Physician Assistant CurrentSince Sep 27, 2021 Accepting new patients
Emergency Medicine Specialists Inc Physician Assistant Past Accepting new patients
Emergency Medicine Specialists, Inc. Physician Assistant Past Accepting new patients
Emergency Medicine Specialists, Inc. Physician Assistant Past Accepting new patients
Emergency Medicine Specialists, Inc Physician Assistant Past Accepting new patients
Emergency Medicine Specialists Inc Physician Assistant Past Accepting new patients
Emergency Medicine Specialists Inc Physician Assistant Past Accepting new patients
Emergency Medicine Specialists, Inc. Physician Assistant Past Accepting new patients
Emergency Medicine Specialists, Inc Physician Assistant Past Accepting new patients

Locations

3535 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 702-4000

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

450 Washington Jackson Rd
#F
Eaton, OH 45320
Phone (937) 456-8376

100 Kettering Way
Franklin, OH 45005
Phone (937) 458-4700

8701 Troy Pike
Huber Heights, OH 45424
Phone (937) 558-3309

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

3131 Newmark Dr
Ste 220
Miamisburg, OH 45342

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342
Phone (937) 384-8791

6147 State Route 122
Middletown, OH 45005
Phone (513) 261-3410

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

1 Kettering Way
Piqua, OH 45356
Phone (937) 916-2615

2300 N Limestone St
Springfield, OH 45503
Phone (937) 328-7050

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

600 W Main St
Troy, OH 45373
Phone (937) 395-6665

1997 W Centerville Rd
Washington Township, OH 45459
Phone (937) 401-6000

1141 N Monroe Dr
Xenia, OH 45385
Phone (937) 352-2000

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1184264376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 NEWMARK DR STE 220",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453425400",
            "telephone_number": "937-436-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N CLEVELAND AVE STE 130",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430828388",
            "telephone_number": "614-839-1118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-395-8166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Kettering Way",
            "address_purpose": "LOCATION",
            "city": "Piqua",
            "state": "OH",
            "postal_code": "453564146",
            "country_code": "US",
            "telephone_number": "937-916-2625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 W Main St",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "OH",
            "postal_code": "453733384",
            "country_code": "US",
            "telephone_number": "937-980-7010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1997 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454593811",
            "country_code": "US",
            "telephone_number": "937-401-6228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454057538",
            "country_code": "US",
            "telephone_number": "937-723-3211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450F Washington Jackson Rd",
            "address_purpose": "LOCATION",
            "city": "Eaton",
            "state": "OH",
            "postal_code": "453208699",
            "country_code": "US",
            "telephone_number": "937-456-8376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6147 State Route 122",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450055201",
            "country_code": "US",
            "telephone_number": "513-261-3410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Kettering Way",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "OH",
            "postal_code": "450051155",
            "country_code": "US",
            "telephone_number": "937-458-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Pentagon Blvd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454311705",
            "country_code": "US",
            "telephone_number": "937-702-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1141 N Monroe Dr",
            "address_purpose": "LOCATION",
            "city": "Xenia",
            "state": "OH",
            "postal_code": "453851619",
            "country_code": "US",
            "telephone_number": "937-352-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8701 Old Troy Pike",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241066",
            "country_code": "US",
            "telephone_number": "937-558-3338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453427615",
            "country_code": "US",
            "telephone_number": "937-384-8791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COUCH",
        "first_name": "MAXWELL",
        "middle_name": "BENJAMIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-15",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.