NPIMap

Organization Active NPI

Samaritan Family Care Inc

Doing business as Huber Heights Samaritan Pediatrics

  • Pediatrics Physician
  • Huber Heights, OH
National Provider Identifier
1235182668
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SAMARITAN FAMILY CARE INC
Doing business as
Huber Heights Samaritan Pediatrics
Practice address
6251 Good Samaritan Way
Suite 210C
Huber Heights, OH 45424-1051
Phone
(937) 233-3910
Fax
(937) 233-8389
NPI assigned
May 18, 2006
Last updated
Jan 4, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SAMARITAN FAMILY CARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Authorized official

Name
Kenneth Prunier
Title
Ceo/President
Phone
(937) 208-8213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

6251 Good Samaritan Way
Suite 210C
Huber Heights, OH 45424-1051

Mailing address

3170 Kettering Blvd BLDG B3
Moraine, OH 45439-1924
Phone (937) 991-3100

Other identifiers 1

IdentifierTypeStateIssuer
0230502MedicaidOH

Other names 1

  • Huber Heights Samaritan Pediatrics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Samaritian Family Care2 organizations share this tax ID, including this one
Part of
Samaritian Family Care

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3170 Kettering Blvd
Bldg B3
Moraine, OH 45439
Phone (937) 991-3188

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609718400000",
    "number": "1235182668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 KETTERING BLVD BLDG B3",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391924",
            "telephone_number": "937-991-3100",
            "fax_number": "937-233-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6251 GOOD SAMARITAN WAY",
            "address_2": "SUITE 210C",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454241051",
            "telephone_number": "937-233-3910",
            "fax_number": "937-233-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN FAMILY CARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAMARITAN FAMILY CARE INC",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A",
        "authorized_official_last_name": "PRUNIER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "937-208-8213"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0230502",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huber Heights Samaritan Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huber Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.