Active NPI
Premier Health Specialists Inc
- Internal Medicine Physician
- Moraine, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- PREMIER HEALTH SPECIALISTS INC
- Practice address
- 3170 Kettering Blvd
Building B 3Rd Floor
Moraine, OH 45439-1924 - Phone
- (937) 991-3188
- Fax
- (937) 223-9811
- NPI assigned
- Aug 24, 2009
- Last updated
- Jul 27, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Renee Mock
- Title
- VP & Cfo - PPN & Fidelity
- Phone
- (937) 208-6439
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | ||
| Nurse Practitioner | 363L00000X | NU | ||
| Clinical Psychologist | 103TC0700X | NU | ||
| Transplant Surgery Physician | 204F00000X | NU | ||
| Family Medicine Physician | 207Q00000X | NU | ||
| Internal Medicine Physician | 207R00000X | NU | Primary | |
| Cardiovascular Disease Physician | 207RC0000X | NU | ||
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | NU | ||
| Interventional Cardiology Physician | 207RI0011X | NU | ||
| Infectious Disease Physician | 207RI0200X | NU | ||
| Nuclear Cardiology Physician | 207UN0901X | NU | ||
| Obstetrics & Gynecology Physician | 207V00000X | NU | ||
| Surgery Physician | 208600000X | NU | ||
| Urology Physician | 208800000X | NU | ||
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | NU |
Addresses
Primary practice location
3170 Kettering Blvd
Building B 3Rd Floor
Moraine, OH 45439-1924
Mailing address
3170 Kettering Blvd
Building B 3Rd Floor
Moraine, OH 45439-1924
Phone (937) 991-3188
Other practice location 1
2400 Lakeview Dr Ste 210
Beavercreek, OH 45431-2581
Phone (937) 312-1661
Other practice location 2
2400 Lakeview Dr Ste 220
Beavercreek, OH 45431-2581
Phone (937) 320-0630
Other practice location 3
2300 Miami Valley Dr Ste 380B
Centerville, OH 45459-1297
Phone (937) 832-9310
Other practice location 4
9000 N Main St Ste 233
Englewood, OH 45415-1184
Phone (937) 832-9310
Other practice location 5
600 Aviator Ct
Ste 220
Vandalia, OH 45377
Phone (937) 335-3518
Other practice location 6
600 Aviator Ct
Ste 210
Vandalia, OH 45377
Phone (937) 335-3561
Other practice location 7
2300 Miami Valley Dr Ste 260
Centerville, OH 45459-1294
Phone (937) 438-7800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0081671 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050610000010 | OH | Part B Supplier - Clinic/Group Practice | 5597708594 | Receives reassigned benefits from 938 practitioners |
National Provider Directory
National Provider DirectoryLocations
2400 Lakeview Dr
Ste 210
Beavercreek, OH 45431
Phone (937) 312-1661
2400 Lakeview Dr
Ste 220
Beavercreek, OH 45431
Phone (937) 320-0630
2400 Lakeview Dr
Ste 260B
Beavercreek, OH 45431
Phone (937) 208-3463
2300 Miami Valley Dr
Fl 4
Centerville, OH 45459
Phone (937) 276-8320
2300 Miami Valley Dr
Ste 380B
Centerville, OH 45459
Phone (937) 832-9310
2350 Miami Valley Dr
Ste 410
Centerville, OH 45459
Phone (937) 281-2370
2400 Miami Valley Dr
#1000
Centerville, OH 45459
1 Wyoming St
#F1
Dayton, OH 45409
Phone (937) 208-2516
1 Wyoming St
Ste 3115A
Dayton, OH 45409
Phone (937) 734-4363
1 Wyoming St
Ste 4140A
Dayton, OH 45409
Phone (937) 208-4110
2350 Miami Valley Dr
Ste 310
Dayton, OH 45459
Phone (937) 435-4263
2350 Miami Valley Dr
Ste 320A
Dayton, OH 45459
Phone (937) 312-1661
30 E Apple St
#L200
Dayton, OH 45409
Phone (937) 208-2020
6251 Miami Valley Way
Ste 120B
Huber Heights, OH 45424
Phone (937) 832-4773
6615 Cincinnati Dayton Rd
Ste B
Liberty Township, OH 45044
Phone (937) 832-9310
400 Sugar Camp Cir
Ste 200
Oakwood, OH 45409
Phone (937) 262-7819
3130 N County Road 25A
Ste 114
Troy, OH 45373
Phone (937) 440-7665
600 Aviator Ct
Ste 220
Vandalia, OH 45377
Phone (937) 335-3518
Practitioners & affiliated clinicians
Practitioners 954
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Interventional Cardiology Physician
- Franklin, OH
- NPI 1972714251
Cardiovascular Disease
-
- Interventional Cardiology Physician
- Dayton, OH
- NPI 1164425443
Cardiovascular Disease
-
- Interventional Cardiology Physician
- Dayton, OH
- NPI 1356347421
Cardiovascular Disease
-
- Women's Health Nurse Practitioner
- Dayton, OH
- NPI 1326183773
-
- Family Nurse Practitioner
- Troy, OH
- NPI 1295597086
-
- Surgery Physician
- Middletown, OH
- NPI 1952628778
-
- Family Nurse Practitioner
- Dayton, OH
- NPI 1407113442
-
- Family Medicine Physician
- Middletown, OH
- NPI 1982718813
-
- Cardiovascular Disease Physician
- Englewood, OH
- NPI 1568802973
Internal Medicine
-
- Cardiovascular Disease Physician
- Centerville, OH
- NPI 1952721060
-
- Women's Health Nurse Practitioner
- Oakwood, OH
- NPI 1245565100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251072000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1785110400000",
"number": "1194958223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3170 KETTERING BLVD",
"address_2": "BUILDING B 3RD FLOOR",
"city": "MORAINE",
"state": "OH",
"postal_code": "454391924",
"telephone_number": "937-991-3188",
"fax_number": "937-223-9811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3170 KETTERING BLVD",
"address_2": "BUILDING B 3RD FLOOR",
"city": "MORAINE",
"state": "OH",
"postal_code": "454391924",
"telephone_number": "937-991-3188",
"fax_number": "937-223-9811"
}
],
"practiceLocations": [
{
"address_1": "2400 Lakeview Dr Ste 210",
"address_purpose": "LOCATION",
"city": "Beavercreek",
"state": "OH",
"postal_code": "454312581",
"country_code": "US",
"telephone_number": "937-312-1661",
"fax_number": "937-312-1701",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2400 Lakeview Dr Ste 220",
"address_purpose": "LOCATION",
"city": "Beavercreek",
"state": "OH",
"postal_code": "454312581",
"country_code": "US",
"telephone_number": "937-320-0630",
"fax_number": "937-320-0633",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2300 Miami Valley Dr Ste 380B",
"address_purpose": "LOCATION",
"city": "Centerville",
"state": "OH",
"postal_code": "454591297",
"country_code": "US",
"telephone_number": "937-832-9310",
"fax_number": "937-832-8613",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9000 N Main St Ste 233",
"address_purpose": "LOCATION",
"city": "Englewood",
"state": "OH",
"postal_code": "454151184",
"country_code": "US",
"telephone_number": "937-832-9310",
"fax_number": "937-832-8613",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "600 Aviator Ct",
"address_2": "Ste 220",
"address_purpose": "LOCATION",
"city": "Vandalia",
"state": "OH",
"postal_code": "45377",
"country_code": "US",
"telephone_number": "937-335-3518",
"fax_number": "937-332-6857",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "600 Aviator Ct",
"address_2": "Ste 210",
"address_purpose": "LOCATION",
"city": "Vandalia",
"state": "OH",
"postal_code": "45377",
"country_code": "US",
"telephone_number": "937-335-3561",
"fax_number": "937-339-1213",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2300 Miami Valley Dr Ste 260",
"address_purpose": "LOCATION",
"city": "Centerville",
"state": "OH",
"postal_code": "454591294",
"country_code": "US",
"telephone_number": "937-438-7800",
"fax_number": "937-438-7811",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "PREMIER HEALTH SPECIALISTS INC",
"organizational_subpart": "NO",
"enumeration_date": "2009-08-24",
"last_updated": "2026-07-27",
"certification_date": "2026-07-27",
"status": "A",
"authorized_official_last_name": "MOCK",
"authorized_official_first_name": "RENEE",
"authorized_official_title_or_position": "VP & CFO - PPN & FIDELITY",
"authorized_official_telephone_number": "937-208-6439"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "204F00000X",
"taxonomy_group": "",
"desc": "Transplant Surgery",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207UN0901X",
"taxonomy_group": "",
"desc": "Nuclear Medicine, Nuclear Cardiology",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0081671",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Moraine, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.