Organization Active NPI

Kettering Network Radiologists Inc

  • Diagnostic Radiology Physician
  • Kettering, OH
National Provider Identifier
1346299153
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 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
Last updated
Apr 22, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Authorized official

Name
Ronald J Fadell, MDNPI 1912957796
Title
President
Phone
(937) 296-7202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

3535 Southern Blvd
Kettering, OH 45429-1221

Mailing address

L-3402
Columbus, OH 43260
Phone (614) 430-5707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, FL, IL, WA, GA, TX, OK, PA, CA, MT, NC, CT, KY, MI, CO, IN, TN, MO, AK, NV, MA, VA22 enrollments

Enrollment records 22

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory

Locations

305 E 55th St
Apt 108
New York, NY 10022
Phone (212) 224-0087

L 3402
Columbus, OH 43260

L3402
Columbus, OH 43260
Phone (814) 444-1919

1222 S Patterson Blvd
Ste 400
Dayton, OH 45402
Phone (937) 496-2600

1977 Miamisburg Centerville Rd
Dayton, OH 45459

30 W Rahn Rd
Dayton, OH 45429
Phone (813) 228-3117

6661 Clyo Rd
Dayton, OH 45459
Phone (937) 425-4000

7740 Washington Village Dr
Ste 1
Dayton, OH 45459

7740 Washington Village Dr
Ste 140
Dayton, OH 45459
Phone (937) 439-7420

1250 W National Rd
Englewood, OH 45315
Phone (937) 558-3062

909 E 2nd St
Franklin, OH 45005
Phone (937) 746-8357

909 E 2nd St
Ste C
Franklin, OH 45005

3700 Southern Blvd
Ste 106
Kettering, OH 45429
Phone (937) 281-3840

424 E Stroop Rd
#B
Kettering, OH 45429

3451 Newmark Dr
Miamisburg, OH 45342
Phone (937) 297-6307

825 N Main St
Ste 110
Springboro, OH 45066
Phone (937) 762-5000

Practitioners & affiliated clinicians

Practitioners 131

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.

View all 131

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366588800000",
    "number": "1346299153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "L-3402",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43260",
            "telephone_number": "614-430-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-296-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETTERING NETWORK RADIOLOGISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2013-04-22",
        "status": "A",
        "authorized_official_last_name": "FADELL",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-296-7202",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Apr 22, 2013; 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.

Verify at the official NPI Registry.