Active NPI
Kathryn Lorraine Dearing, M.D.
- Pediatric Adolescent Medicine Physician
- Tipp City, OH
National Provider Identifier
1649365032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 35090470
- Practice address
- 1483 W Main St
Tipp City, OH 45371-2803 - Phone
- (937) 667-7711
- Fax
- (937) 667-8067
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01054163A | IN | |
| Pediatric Adolescent Medicine Physician | 2080A0000X | 35090470 | OH | Primary |
Addresses
Primary practice location
1483 W Main St
Tipp City, OH 45371-2803
Mailing address
3155 Running Deer Trail
Franklin, OH 45005
Phone (937) 760-5903
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01054163A | IN | MD | Pediatrics Physician |
| 35090470 | OH | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Child and Adolescent Specialty Care of Dayton Inc. | Adolescent Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
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- Pediatric Adolescent Medicine Physician
- Tipp City, OH
- NPI 1881794113
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502841600000",
"number": "1649365032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3155 RUNNING DEER TRAIL",
"city": "FRANKLIN",
"state": "OH",
"postal_code": "45005",
"telephone_number": "937-760-5903",
"fax_number": "937-667-8067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1483 W MAIN ST",
"city": "TIPP CITY",
"state": "OH",
"postal_code": "453712803",
"telephone_number": "937-667-7711",
"fax_number": "937-667-8067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEARING",
"first_name": "KATHRYN",
"middle_name": "LORRAINE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2017-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01054163A",
"primary": false
},
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "OH",
"license": "35090470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tipp City, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.