Kettering Network Radiologists Inc
Organization Active NPI Diagnostic Radiology Physician · Kettering, OH
NPI 1346299153 · NPPES record last updated Apr 22, 2013
Key facts
- NPI
- 1346299153
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- KETTERING NETWORK RADIOLOGISTS INC
- Practice address
- 3535 Southern Blvd
Kettering, OH 45429-1221 - Phone
- (937) 296-7202
- NPI assigned
- May 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Ronald J Fadell, MD
- Title
- President
- Phone
- (937) 296-7202
Practitioners 130
-
Joseph Blake, MD
-
William Boyce, MD
-
Rick L Brittain, MD
-
Jason Frank Broomhall, M.D.
-
Michael Caccamo, DO
-
Jarrod Dean Curry, D.O.
-
Jeffrey D. Cushman, D.O.
-
Ronald J Fadell, MD
-
Bruce E Gearhart, MD
-
Neelima Gorantla, M.D.
-
Jared Anthony Griffith, D.O.
-
Martin P Jacobs, MD
-
Kunal Karani, MD
-
Matthew R Kinzie, M.D.
-
Ella Brooks Kundu, M.D.
-
Sharal Mall, DO
-
Sheila Manion, MD
-
William M Meyers, DO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (22 enrollments) in OH, FL, IL, WA, GA, TX, OK, PA, CA, MT, NC, CT, KY, MI, CO, IN, TN, MO, AK, NV, MA, VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040407001016 | OH | Part B Supplier - Clinic/Group Practice | 7618960303 | Receives reassigned benefits from 69 practitioners |
| O20150810002511 | FL | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 6 practitioners Practice locations: St Augustine, FL; Sarasota, FL; Newberry, FL; Fort Myers, FL |
| O20160204000371 | IL | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 3 practitioners Practice locations: Chicago, IL; Northbrook, IL; Oak Brook, IL |
| O20160217000878 | WA | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 1 practitioner Practice locations: Seattle, WA |
| O20160602001352 | GA | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 1 practitioner Practice locations: Decatur, GA |
| O20160630000573 | TX | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 2 practitioners Practice locations: Dallas, TX; Spring, TX |
| O20160711002092 | OK | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 1 practitioner Practice locations: Edmond, OK |
| O20161110001170 | PA | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 2 practitioners Practice locations: Mechanicsburg, PA; Philadelphia, PA |
| O20170209001203 | CA | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 9 practitioners Practice locations: Sunnyvale, CA; San Jose, CA; San Francisco, CA; San Diego, CA; San Clemente, CA; Sacramento, CA; Rancho Cucamonga, CA; Los Angeles, CA… |
| O20180525001315 | MT | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 1 practitioner Practice locations: Billings, MT |
| O20180530001846 | NC | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 1 practitioner Practice locations: Brevard, NC |
| O20181024001074 | CT | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 1 practitioner Practice locations: Hamden, CT |
| O20200512003446 | KY | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 5 practitioners Practice locations: Taylor Mill, KY; Prospect, KY; Louisville, KY; Campbellsville, KY |
| O20200722001025 | MI | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 3 practitioners Practice locations: Ada, MI; Spring Lake, MI; Royal Oak, MI |
| O20210518001233 | CO | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 3 practitioners Practice locations: Glenwood Springs, CO; Parker, CO |
| O20211209001406 | IN | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 44 practitioners Practice locations: Angola, IN |
| O20221118002281 | TN | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 2 practitioners Practice locations: Knoxville, TN |
| O20240410001970 | MO | Part B Supplier - Clinic/Group Practice | 7618960303 | Practice locations: Kansas City, MO |
| O20240603000857 | AK | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 1 practitioner Practice locations: Eagle River, AK |
| O20250304003696 | NV | Part B Supplier - Clinic/Group Practice | 7618960303 | Practice locations: Las Vegas, NV |
| O20251013000139 | MA | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 1 practitioner Practice locations: Boston, MA |
| O20251022004109 | VA | Part B Supplier - Clinic/Group Practice | 7618960303 |
Receives reassigned benefits from 1 practitioner Practice locations: Charlottesville, VA; Troy, VA |
National Provider Directory
Locations
305 E 55th St
Apt 108
New York, NY 10022
Phone (212) 224-0087
121 Westfield Dr
Archbold, OH 43502
Phone (419) 445-2015
2510 Commons Blvd
Ste 120
Beavercreek, OH 45431
Phone (937) 320-0630
L3402
Columbus, OH 43260
Phone (814) 444-1919
L 3402
Columbus, OH 43260
2591 Miamisburg Centerville Rd
Ste 100
Dayton, OH 45459
Phone (937) 296-7227
1977 Miamisburg Centerville Rd
Dayton, OH 45459
6661 Clyo Rd
Dayton, OH 45459
Phone (937) 425-4000
6438 Wilmington Pike
Dayton, OH 45459
Phone (937) 395-8666
1250 W National Rd
Englewood, OH 45315
Phone (937) 558-3062
909 E 2nd St
Ste C
Franklin, OH 45005
540 Lincoln Park Blvd
Ste 100
Kettering, OH 45429
Phone (937) 299-0900
580 Lincoln Park Blvd
Ste 200
Kettering, OH 45429
Phone (513) 299-0099
424 E Stroop Rd
#B
Kettering, OH 45429
3451 Newmark Dr
Miamisburg, OH 45342
Phone (937) 297-6307
415 Byers Rd
Ste 300
Miamisburg, OH 45342
Phone (937) 866-2494
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes |
Addresses
Primary practice location
3535 Southern Blvd
Kettering, OH 45429-1221
Mailing address
L-3402
Columbus, OH 43260
Phone (614) 430-5707
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000006173 | Other | ANTHEM | |
| CB4569 | Other | MEDICARE RAILROAD | |
| 0383160 | Medicaid | OH |
Other providers in Kettering, OH
- Kettering Medical Center
- Kettering Medical Center
- Kettering Medical Center
- Kettering Medical Center
- Kettering Medical Center
- Kettering Pathology Associates Inc
- Kettering Physiatrists, Inc.
- Kettering Physician Network
- Kettering Podiatry Associates LLC
- Kettering Radiologist Imaging Center
All providers in Kettering, OH · Diagnostic Radiology Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.