Individual provider Active NPI

Kwasi A. Nenonene, M.D.

  • Family Medicine Physician
  • Dayton, OH
National Provider Identifier
1184617276
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35080410 Issued in OH
Practice address
8769 N Main St
Dayton, OH 45415-1392
Phone
(937) 275-6341
Fax
(937) 275-6342
NPI assigned
Aug 24, 2005
Last updated
May 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35080410 OH Primary

Addresses

Primary practice location

8769 N Main St
Dayton, OH 45415-1392

Mailing address

8769 N Main St
Dayton, OH 45415-1392
Phone (937) 275-6341

Other identifiers 1

IdentifierTypeStateIssuer
2286093MedicaidOH

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
I20090928000001 OH Practitioner - Internal MedicinePractitioner - Family Practice 2264453422 Practice locations: Dayton, OH

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Wright State University Boonshoft School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8769 N Main St
Dayton, OH 45415-1327
Phone (937) 275-6341

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NPI 1154488534 Family Medicine PastSince Jan 1, 1990 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1184617276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8769 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151392",
            "telephone_number": "937-275-6341",
            "fax_number": "937-275-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8769 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151392",
            "telephone_number": "937-275-6341",
            "fax_number": "937-275-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NENONENE",
        "first_name": "KWASI",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35080410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2286093",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.