Individual provider Active NPI

Erin Gardner Vitale, RN, BSN

  • Adult Health Nurse Practitioner
  • Kettering, OH
National Provider Identifier
1639599277
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN.CNP.16273 Issued in OH
Practice address
3535 Southern Blvd
Kettering, OH 45429-1221
Phone
(937) 395-6665
Fax
(937) 395-6668
NPI assigned
Apr 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN356439 OH
Adult Health Nurse Practitioner 363LA2200X APRN.CNP.16273 OH Primary

Addresses

Primary practice location

3535 Southern Blvd
Kettering, OH 45429-1221

Mailing address

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-8394

Other practice location 1

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-8394

Other identifiers 1

IdentifierTypeStateIssuer
0107049MedicaidOH

Other names 1

  • Ms. Erin Michelle Gardner Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address evitale528290@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140804001941 OH Practitioner - Nurse Practitioner 6608093349 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wright State University Boonshoft School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mvhe IncGroup PAC ID 9537066584, 399 clinicians
Sinclair Physician Services, LLCGroup PAC ID 9830536911, 128 clinicians
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-8394

122 Wyoming St
Dayton, OH 45409-2731
Phone (937) 438-8640

2400 Miami Valley Dr
Centerville, OH 45459-4774
Phone (937) 208-8394

2451 Wayne Ave
Dayton, OH 45420-1893
Phone (937) 252-1831

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.23 of 100Reported as group
Quality
83.64
Promoting interoperability
100
Improvement activities
40
Cost
73.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN356439OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc CurrentSince Dec 29, 2022 Accepting new patients
Mvhe Inc CurrentSince Jul 17, 2014 Accepting new patients
Mvhe Inc CurrentSince Jul 17, 2014 Accepting new patients
Sinclair Physician Services, LLC CurrentSince Mar 18, 2024 Accepting new patients
Premier Health Specialists Inc CurrentSince Feb 24, 2025 Accepting new patients
Premier Health Specialists Inc CurrentSince Feb 24, 2025 Accepting new patients
Hisey Physician Services, LLC CurrentSince May 1, 2024 Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients

Locations

722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

2400 Miami Valley Dr
Dayton, OH 45459
Phone (937) 208-8394

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

122 Wyoming St
Dayton, OH 45409
Phone (937) 438-8640

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

9000 N Main St
Englewood, OH 45415
Phone (937) 208-8394

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

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

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

3130 N County Road 25A
Troy, OH 45373
Phone (937) 440-4000

Organizations & group practices 8

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 2

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": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1639599277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092722",
            "telephone_number": "937-208-8394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-395-6665",
            "fax_number": "937-395-6668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Wyoming St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454092722",
            "country_code": "US",
            "telephone_number": "937-208-8394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VITALE",
        "first_name": "ERIN",
        "middle_name": "GARDNER",
        "name_prefix": "Mrs.",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-22",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "RN356439",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP.16273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0107049",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "evitale528290@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3535 Southern Blvd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291221",
            "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": "3535 Southern Blvd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "GARDNER",
            "middle_name": "MICHELLE",
            "prefix": "MS.",
            "credential": "RN, BSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.