NPIMap

Organization Active NPI

Kettering Medical Center

  • Rural Health Clinic/Center
  • Eaton, OH
National Provider Identifier
1467090670
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
KETTERING MEDICAL CENTER
Practice address
450B Washington Jackson Rd Ste 104
Eaton, OH 45320-7601
Phone
(937) 456-8340
NPI assigned
Dec 18, 2019
Organization subpart
Yes
Parent organization
KETTERING MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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

Authorized official

Name
Dann Hotelling
Title
Vice President of Finance
Phone
(937) 762-1644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

450B Washington Jackson Rd Ste 104
Eaton, OH 45320-7601

Mailing address

2110 Leiter Rd
Miamisburg, OH 45342-3598
Phone (937) 384-4506

Other practice location 1

450B Washington Jackson Rd Ste 105
Eaton, OH 45320-7601
Phone (937) 456-8350

Other practice location 2

450B Washington Jackson Rd Ste 108
Eaton, OH 45320-7601
Phone (937) 456-8330

Other names 1

  • Kettering Health Network Preble Health Center Doing business as

National Provider Directory

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

Other organizations with this tax ID 11

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

Locations

450B Washington Jackson Rd
Ste 108
Eaton, OH 45320
Phone (937) 456-8330

450B Washington Jackson Rd
Ste 105
Eaton, OH 45320
Phone (937) 456-8300

450B Washington Jackson Rd
Ste 104
Eaton, OH 45320
Phone (937) 456-8300

NPI Registry JSON

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586131200000",
    "number": "1467090670",
    "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": "937-384-4506",
            "fax_number": "937-522-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450B WASHINGTON JACKSON RD STE 104",
            "city": "EATON",
            "state": "OH",
            "postal_code": "453207601",
            "telephone_number": "937-456-8340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450B Washington Jackson Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Eaton",
            "state": "OH",
            "postal_code": "453207601",
            "country_code": "US",
            "telephone_number": "937-456-8350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450B Washington Jackson Rd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Eaton",
            "state": "OH",
            "postal_code": "453207601",
            "country_code": "US",
            "telephone_number": "937-456-8330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KETTERING MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KETTERING MEDICAL CENTER",
        "enumeration_date": "2019-12-18",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A",
        "authorized_official_last_name": "HOTELLING",
        "authorized_official_first_name": "DANN",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "937-762-1644"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kettering Health Network Preble Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eaton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.