Organization Active NPI

Dayton Chest Medicine Inc

  • Specialist
  • Kettering, OH
National Provider Identifier
1366469207
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
DAYTON CHEST MEDICINE INC
Practice address
3080 Ackerman Blvd
Ste 100
Kettering, OH 45429-3555
Phone
(937) 396-1605
Fax
(937) 396-1607
NPI assigned
Jul 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Authorized official

Name
Dr. Robert E Smith, M.D.NPI 1205924859
Title
President
Phone
(937) 396-1605

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
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

3080 Ackerman Blvd
Ste 100
Kettering, OH 45429-3555

Mailing address

3080 Ackerman Blvd
Ste 100
Kettering, OH 45429-3555
Phone (937) 396-1605

Other identifiers 1

IdentifierTypeStateIssuer
CC3727OtherOHRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050510000367 OH Part B Supplier - Clinic/Group Practice 4183664105 Receives reassigned benefits from 7 practitioners
Practice locations: Kettering, OH

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
36D0974388Dayton Chest Medicine Coagulation Clinic3080 Ackerman Boulevard Suite 100, Kettering, OH 45429Certificate of waiverJun 5, 2028

National Provider Directory

National Provider Directory

Locations

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

1 Elizabeth Pl
Fl 3
Dayton, OH 45417
Phone (937) 461-5200

3080 Ackerman Blvd
Ste 100
Kettering, OH 45429
Phone (937) 396-1605

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367280000000",
    "number": "1366469207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3080 ACKERMAN BLVD",
            "address_2": "STE 100",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454293555",
            "telephone_number": "937-396-1605",
            "fax_number": "937-396-1607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 ACKERMAN BLVD",
            "address_2": "STE 100",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454293555",
            "telephone_number": "937-396-1605",
            "fax_number": "937-396-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYTON CHEST MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2013-04-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-396-1605",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC3727",
            "state": "OH"
        }
    ],
    "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 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.