Individual provider Active NPI

Kayla Sierra Kearney, PA-C

  • Physician Assistant
  • Centerville, OH
National Provider Identifier
1750197190
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1229606 Issued in OH
Practice address
2350 Miami Valley Dr Ste 500
Centerville, OH 45459-4780
Phone
(937) 293-1622
Fax
(937) 245-6308
NPI assigned
Dec 10, 2024
Last updated
Apr 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1229606 OH Primary

Addresses

Primary practice location

2350 Miami Valley Dr Ste 500
Centerville, OH 45459-4780

Mailing address

6680 Poe Ave Ste 200
Dayton, OH 45414-2855
Phone (937) 293-1622

Other practice location 1

9000 N Main St Ste 200
Englewood, OH 45415-1165
Phone (937) 293-1622

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkearney2054590@direct.premierhealth.com

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
I20250326002996 OH Practitioner - Physician Assistant 9335662758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dayton Physicians LLCGroup PAC ID 1456374859, 40 clinicians

Practice addresses (Care Compare)

2350 Miami Valley Dr
Suite 500
Centerville, OH 45459-4780
Phone (937) 293-1622

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1229606OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Physicians, LLC CurrentSince Mar 24, 2025 Accepting new patients

Locations

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

2350 Miami Valley Dr
Ste 500
Dayton, OH 45459
Phone (937) 425-0003

6680 Poe Ave
Ste 200
Dayton, OH 45414

9000 N Main St
Ste 200
Englewood, OH 45415
Phone (937) 495-0000

Interoperability endpoints

  • Direct secure messaging: kkearney2054590@direct.premierhealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1733788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1750197190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6680 POE AVE STE 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454142855",
            "telephone_number": "937-293-1622",
            "fax_number": "937-280-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 MIAMI VALLEY DR STE 500",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594780",
            "telephone_number": "937-293-1622",
            "fax_number": "937-245-6308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9000 N Main St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "OH",
            "postal_code": "454151165",
            "country_code": "US",
            "telephone_number": "937-293-1622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEARNEY",
        "first_name": "KAYLA",
        "middle_name": "SIERRA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-10",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "1229606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkearney2054590@direct.premierhealth.com",
            "affiliation": "N",
            "address_1": "2350 Miami Valley Dr Ste 500",
            "city": "Centerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454594780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

Verify at the official NPI Registry.