Individual provider Active NPI

Haley Jean Petges, RD

  • Registered Dietitian
  • Dayton, OH
National Provider Identifier
1609753607
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1065869
Practice address
2555 S Dixie Dr Ste 112
Dayton, OH 45409-1532
Phone
(937) 220-6611
NPI assigned
Aug 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1065869 Primary

Addresses

Primary practice location

2555 S Dixie Dr Ste 112
Dayton, OH 45409-1532

Mailing address

793 Cliffside Dr
Fairborn, OH 45324-5855
Phone (262) 960-1933

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250922002059 OH Practitioner - Registered Dietitian Or Nutrition Professional 9234633298 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

1989 Miamisburg Centerville Rd
Suite 201
Centerville, OH 45459-3858
Phone (937) 401-7550

Hospital & facility affiliations

  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lifecare Alliance CurrentSince Aug 26, 2025 Accepting new patients
Lifecare Alliance Dietitian, Registered CurrentSince Aug 26, 2025 Accepting new patients

Locations

1699 W Mound St
Columbus, OH 43223
Phone (614) 278-3130

2555 S Dixie Dr
Ste 112
Dayton, OH 45409
Phone (937) 220-6611

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1755648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1609753607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 CLIFFSIDE DR",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453245855",
            "telephone_number": "262-960-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 S DIXIE DR STE 112",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454091532",
            "telephone_number": "937-220-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETGES",
        "first_name": "HALEY",
        "middle_name": "JEAN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-20",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "1065869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.