Kettering Independent Medical Group Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

KETTERING INDEPENDENT MEDICAL GROUP INC

Practice address

3737 Southern Blvd
Suite 2100
Kettering, OH 45429-1262

Phone

(937) 294-1632

NPI assigned

Jan 18, 2011

Last updated

Jun 13, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Timothy Y Ko

Title

Cfo

Phone

(937) 558-3223

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Alliance Physicians Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Kettering Independent Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Miamisburg, OH
  • NPI 1083911390
  NPD tax ID
• Kettering Independent Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Dayton, OH
  • NPI 1124323514
  NPD tax ID
• Kettering Independent Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Vandalia, OH
  • NPI 1609171255
  NPD tax ID
• Kettering Independent Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Beavercreek, OH
  • NPI 1881999449
  NPD tax ID

Locations

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

{
    "created_epoch": "1295308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686614400000",
    "number": "1679878060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PRESTIGE PL STE 550",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453426115",
            "telephone_number": "937-762-1310",
            "fax_number": "937-522-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 SOUTHERN BLVD",
            "address_2": "SUITE 2100",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291262",
            "telephone_number": "937-294-1632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETTERING INDEPENDENT MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-18",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "KO",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "937-558-3223"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FECA",
            "identifier": "614010105",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kettering Card and Vas Surg
• Kettering Cardiothoracic and Vascular Surgeons, Inc
• Kettering Chiropractic Center Inc
• Kettering City School District
• Kettering Health Network
• Kettering Integrated Services LLC (Renew Boutique and Spa)
• Kettering Medical Center (Kettering Health Main Campus)
• Kettering Medical Center (Kettering Network HomeCare)
• Kettering Medical Center (Precious Beginnings Home Care)
• Kettering Medical Center (Kettering Reproductive Medicine)

• Durable Medical Equipment & Medical Supplies in Kettering, OH
• Providers in Kettering, OH by specialty
• Durable Medical Equipment & Medical Supplies in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.