Individual provider Active NPI

Aimee George Russell, M.D.

  • Radiation Oncology Physician
  • Kettering, OH
National Provider Identifier
1528008679
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
35086805 Issued in OH
Practice address
3700 Southern Blvd.
Suite 101
Kettering, OH 45429-1226
Phone
(937) 281-3810
Fax
(937) 281-3812
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 35086805 OH Primary

Addresses

Primary practice location

3700 Southern Blvd.
Suite 101
Kettering, OH 45429-1226

Mailing address

3700 Southern Blvd.
Suite 101
Kettering, OH 45429-1226
Phone (937) 281-3810

Other identifiers 1

IdentifierTypeStateIssuer
2697407MedicaidOH

Other names 1

  • Dr. Aimee Jeanne George Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address arussell189325@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20061208000208 OH Practitioner - Radiation Oncology 3870592462 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35086805OHMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc CurrentSince Dec 29, 2022 Accepting new patients
Dayton Physicians, LLC Past Accepting new patients

Locations

3525 Pentagon Blvd
Ste 101
Beavercreek, OH 45431
Phone (937) 702-4060

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

3700 Southern Blvd
Ste 101
Kettering, OH 45429
Phone (937) 281-3810

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

1141 N Monroe Dr
Xenia, OH 45385
Phone (937) 352-2000

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1528008679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 SOUTHERN BLVD.",
            "address_2": "SUITE 101",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291226",
            "telephone_number": "937-281-3810",
            "fax_number": "937-281-3812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 SOUTHERN BLVD.",
            "address_2": "SUITE 101",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291226",
            "telephone_number": "937-281-3810",
            "fax_number": "937-281-3812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "AIMEE",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "OH",
            "license": "35086805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2697407",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arussell189325@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3700 Southern Blvd.",
            "address_2": "Suite 101",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291226",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3700 Southern Blvd.",
            "address_2": "Suite 101",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AIMEE",
            "last_name": "GEORGE",
            "middle_name": "JEANNE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.