NPIMap

Organization Active NPI

Kettering Medical Center

  • General Acute Care Hospital
  • Miamisburg, OH
National Provider Identifier
1316966518
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
1031 Issued in OH
Legal business name
KETTERING MEDICAL CENTER
Practice address
4000 Miamisburg Centerville Rd
Miamisburg, OH 45342-7615
Phone
(937) 866-0551
NPI assigned
Jul 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Authorized official

Name
Timothy Ko
Title
Kettering Health Cfo
Phone
(937) 395-8522

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X OH
General Acute Care Hospital 282N00000X 1031 OH Primary

Addresses

Primary practice location

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342-7615

Mailing address

2110 Leiter Rd
Miamisburg, OH 45342-3598
Phone (937) 914-7601

Other identifiers 1

IdentifierTypeStateIssuer
0414206MedicaidOH

Other names 1

  • Kettering Health Miamisburg Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080108000700 OH Part A Provider - Hospital 2769415348 1 other NPI on this enrollment
Practice locations: Miamisburg, OH; Moraine, OH; Springboro, OH; Franklin, OH

Hospital certification: CCN 360239

Legal name
KETTERING MEDICAL CENTER
Doing business as
KETTERING HEALTH MIAMISBURG
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Feb 16, 1979
Last certification
Jan 21, 2011
Beds
190
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1979 in OH
Enrollment address
4000 Miamisburg Centerville Rd
Miamisburg, OH 45342-7615
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Kettering Health MiamisburgCCN 360239
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0679451Kettering Health Miamisburg - Waived4000 Miamisburg-Centerville Rd, Miamisburg, OH 45342Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Kettering Medical Ctr12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

280 Sierra College Dr
Ste 105
Grass Valley, CA 95945
Phone (530) 273-3400

2150 Leiter Rd
Miamisburg, OH 45342
Phone (937) 384-8791

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kevin L Sharrett Individual Corporate DirectorBoard Member Jan 31, 2024
Michael Gentry Individual Corporate OfficerKettering Health Ceo Jul 3, 2023
Corporate DirectorBoard Member Jan 31, 2024
Marcellus Robinson Individual Corporate OfficerBoard Chair Apr 30, 2024
Corporate Director Apr 30, 2024
Jonathan E Velasco Individual Corporate DirectorBoard Member Jan 31, 2024
Roy Simpson Individual Corporate DirectorBoard Member Jan 31, 2024
Keisha Stubbs-Bone Individual Corporate DirectorBoard Member Jan 31, 2024
Tamara L Thomas Individual Corporate DirectorBoard Member Jan 31, 2024
Robert Weigel Individual Corporate DirectorBoard Member Jan 31, 2024
Adele Riley Individual Corporate DirectorBoard Member Jan 31, 2024
Leslie Neff Individual Corporate DirectorBoard Member Jan 31, 2024
Troy Alan Tyner Individual Corporate DirectorBoard Member Jan 31, 2024
Timothy Y Ko Individual Corporate OfficerKettering Health Cfo Nov 18, 2022
Erica Schneider Individual W-2 Managing EmployeeKH Miamisburg President Oct 2, 2023
Randall J Tanguay Individual Corporate DirectorBoard Member Jan 31, 2024
Kettering Adventist Healthcare Organization, Miamisburg, OH Corporation, Non-profit Operational/Managerial Control Jul 31, 2009 100%
Other Jan 31, 2024
Cherish J Prutzman Individual Corporate DirectorBoard Member Jan 31, 2024
Robert Patterson Individual Corporate DirectorBoard Member Jan 31, 2024

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pam Rehabilitation Hospital of Dayton LLCMiamisburg, OH, CCN 363046 Hospital 5% Or Greater Direct Ownership Interest (45%) May 1, 2023
Kettering Health Main CampusKettering, OH, CCN 367249 Home health agency Operational/Managerial Control (100%)
Other		 Jan 1, 1984
Jan 31, 2024
Bridges Rehab at HomeMason, OH, CCN 368232 Home health agency 5% Or Greater Indirect Ownership Interest Aug 6, 2014
Kettering HomecareKettering, OH, CCN 367778 Home health agency 5% Or Greater Direct Ownership Interest (40%) Apr 1, 2013

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 11

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 29

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

View all 29

Affiliated clinicians 766

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 766

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1316966518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 LEITER RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423598",
            "telephone_number": "937-914-7601",
            "fax_number": "937-522-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MIAMISBURG CENTERVILLE RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453427615",
            "telephone_number": "937-866-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETTERING MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "KO",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "KETTERING HEALTH CFO",
        "authorized_official_telephone_number": "937-395-8522"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "OH",
            "license": "1031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0414206",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kettering Health Miamisburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miamisburg, OH

Sources for this page

Verify at the official NPI Registry.