NPIMap

Organization Active NPI

Dayton Interventional Radiology LLC

  • Vascular & Interventional Radiology Physician
  • Kettering, OH
National Provider Identifier
1316923915
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
DAYTON INTERVENTIONAL RADIOLOGY LLC
Practice address
3075 Governors Place Blvd
Kettering, OH 45409-1323
Phone
(937) 765-3113
NPI assigned
Dec 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Authorized official

Name
Gregg Miller, MD
Title
Sr. Vice President
Phone
(610) 644-8900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0204X Primary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X 36.003246 OH

Addresses

Primary practice location

3075 Governors Place Blvd
Kettering, OH 45409-1323

Mailing address

PO Box 412865
Boston, MA 02241-2865
Phone (610) 644-8900

National Provider Directory

National Provider Directory

Locations

240 W Elmwood Dr
Ste 1000
Dayton, OH 45459
Phone (937) 224-8200

1 Elizabeth Pl
Ste WP4A
Dayton, OH 45417

7790 Dayton Springfield Rd
Fairborn, OH 45324
Phone (937) 340-6200

415 W Russ Rd
Greenville, OH 45331
Phone (937) 548-1224

1000 Michigan St
Ste 203
Sidney, OH 45365

110 S Tippecanoe Dr
Ste C
Tipp City, OH 45371

110 S Tippecanoe Dr
Tipp City, OH 45371
Phone (937) 223-4012

65 S Stanfield Rd
Troy, OH 45373
Phone (513) 339-5011

3006 N County Road 25A
Ste 105
Troy, OH 45373

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1316923915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412865",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412865",
            "telephone_number": "610-644-8900",
            "fax_number": "484-924-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 GOVERNORS PLACE BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454091323",
            "telephone_number": "937-765-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYTON INTERVENTIONAL RADIOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-16",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GREGG",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT",
        "authorized_official_telephone_number": "610-644-8900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36.003246",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.