John P Detherage III, MD

Primary specialty

Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X

License

35150486 Issued in OH

Practice address

7910 Beechmont Ave
Cincinnati, OH 45255-4210

Phone

(513) 232-2663

Fax

(513) 605-1622

NPI assigned

May 5, 2021

Last updated

Oct 14, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, KY, IN3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Emergency MedicineAlso: Sports Medicine

Education

Wright State University Boonshoft School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthocincy Orthopaedics and Sports Medicine PSCGroup PAC ID 3173500196, 163 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bethesda North Hospital, Cincinnati, OH, CCN 360179
• Good Samaritan Hospital Hospital, Cincinnati, OH, CCN 360134
• McCullough-Hyde Memorial Hospital Hospital, Oxford, OH, CCN 360046

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Orthocincy Orthopaedics & Sports Medicine PSC

  • Orthopaedic Surgery Physician
  • Edgewood, KY
  • NPI 1598714560

  IN, OH

  Medicare reassignment Care Compare group NPD
• Qualified Emergency Specialists Inc

  • Emergency Medicine Physician
  • Montgomery, OH
  • NPI 1700872728
  Medicare reassignment NPD
• University of Cincinnati Physicians Company, LLC

  • Family Medicine Physician
  • Cincinnati, OH
  • NPI 1801840434
  Medicare reassignment NPD
• Orthocincy Orthopaedics & Sports Medicine PSC

  • Physical Therapist
  • Montgomery, OH
  • NPI 1003791054
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bethesda Hospital Inc

  • General Acute Care Hospital
  • Cincinnati, OH
  • NPI 1396714663
  Care Compare affiliation
• McCullough-Hyde Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Oxford, OH
  • NPI 1245216183
  Care Compare affiliation
• The Good Samaritan Hospital of Cincinnati, Ohio

  dba Good Samaritan Surgery Center West

  • General Acute Care Hospital
  • Cincinnati, OH
  • NPI 1457964041
  Care Compare affiliation
• The Good Samaritan Hospital of Cincinnati, Ohio

  dba Good Samaritan Endoscopy Center North

  • General Acute Care Hospital
  • Montgomery, OH
  • NPI 1477166064
  Care Compare affiliation
• The Good Samaritan Hospital of Cincinnati, Ohio

  • General Acute Care Hospital
  • Cincinnati, OH
  • NPI 1508835828
  Care Compare affiliation
• The Good Samaritan Hospital of Cincinnati, Ohio

  dba Good Samaritan Hospital - Evendale

  • General Acute Care Hospital
  • Cincinnati, OH
  • NPI 1740893320
  Care Compare affiliation
• The Good Samaritan Hospital of Cincinnati, Ohio

  dba Good Samaritan Hand Surgery Center

  • General Acute Care Hospital
  • Cincinnati, OH
  • NPI 1851904445
  Care Compare affiliation

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1447833504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 S LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 BEECHMONT AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452554210",
            "telephone_number": "513-232-2663",
            "fax_number": "513-605-1622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10506 Montgomery Rd Ste 209",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "OH",
            "postal_code": "452424400",
            "country_code": "US",
            "telephone_number": "513-865-9040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DETHERAGE",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-05",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "IN",
            "license": "01098271A",
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "KY",
            "license": "59124",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35150486",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "59124",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01098271A",
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "OH",
            "license": "35150486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karin J Detchon, RN, CNP
• Nicholas Ross Detchon, CRNA
• Delaney Elizabeth Deters, PA-C
• Janet L Deters, PT
• Abigail Detherage
• Gwendolyn L Detillion, FNP-C
• Jill Marie Detling
• Amy Cecelia Detoro, CNP
• Beth A Detrich, MSW, LISW-S
• Amie Nicole Detzel

• Sports Medicine (Emergency Medicine) Physician in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Sports Medicine (Emergency Medicine) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.