NPIMap

Organization Active NPI

Beavercreek Medical Center

Doing business as Soin Medical Center

  • General Acute Care Hospital
  • Beavercreek, OH
National Provider Identifier
1760764849
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
BEAVERCREEK MEDICAL CENTER
Doing business as
Soin Medical Center
Practice address
3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone
(937) 702-4000
NPI assigned
Sep 14, 2011
Last updated
Jul 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Authorized official

Name
Timothy Ko
Title
Kettering Health Cfo
Phone
(937) 395-8522

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU Primary

Addresses

Primary practice location

3535 Pentagon Blvd
Beavercreek, OH 45431-1705

Mailing address

PO Box 933323
Cleveland, OH 44193-0037
Phone (937) 298-3399

Other identifiers 1

IdentifierTypeStateIssuer
0066896MedicaidOH

Other names 1

  • Soin Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120127000872 OH Part A Provider - Hospital 6608033915 Practice locations: Beavercreek, OH; Springfield, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760764849. Details of each certification follow.

Hospital certification: CCN 360360

Legal name
BEAVERCREEK MEDICAL CENTER
Doing business as
SOIN MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Apr 2, 2012
Last certification
Apr 2, 2012
Beds
206 (160 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jul 31, 2009 in OH
Enrollment address
3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Soin Medical CenterCCN 360360 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2034478Soin Medical Center3535 Pentagon Boulevard, Beavercreek, OH 45431AccreditationNov 13, 2026
36D2119416Soin Medical Center - Waived3535 Pentagon Blvd, Beavercreek, OH 45431Certificate of waiverSep 26, 2026
36D2269636Soin Medical Center - Respiratory Care Department3535 Pentagon Blvd, Beavercreek, OH 45431RegistrationJun 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
Beavercreek Medical Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1500 Rombach Ave
Wilmington, OH 45177
Phone (937) 298-3399

Ownership & related parties

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kevin L Sharrett Individual Corporate DirectorBoard Member Jan 31, 2024
Paul Hoover Individual W-2 Managing Employee Sep 29, 2025
Michael Gentry Individual Corporate OfficerKettering Health Ceo Jul 3, 2023
Corporate DirectorBoard Member Jan 31, 2024
Marcellus Robinson Individual Corporate OfficerBoard Chair Apr 30, 2024
Corporate DirectorBoard Member Apr 30, 2024
Keisha Stubbs-Bone Individual Corporate DirectorBoard Member Jan 31, 2024
Vanessa Oliver-Ward Individual Corporate DirectorBoard Member Feb 5, 2025
Tamara L Thomas Individual Corporate DirectorBoard Member Jan 31, 2024
Robert Weigel Individual Corporate DirectorBoard Member Jan 31, 2024
Adele Riley Individual Corporate DirectorBoard Member Jan 31, 2024
Leslie Neff Individual Corporate DirectorBoard Member Jan 31, 2024
John Sackett Individual Corporate DirectorBoard Member Nov 11, 2024
Troy Alan Tyner Individual Corporate DirectorBoard Member Jan 31, 2024
Harvey Sung Ha Hahn Individual Corporate DirectorBoard Member Feb 5, 2025
Timothy Y Ko Individual Corporate OfficerKettering Health Cfo Nov 18, 2022
Andrew Sutton Individual Corporate DirectorBoard Member Feb 5, 2025
Kettering Adventist Healthcare Organization, Kettering, OH Corporation, Non-profit Operational/Managerial Control Jul 31, 2009 100%
Other Jan 31, 2024
Cherish J Prutzman Individual Corporate DirectorBoard Member Jan 31, 2024
Robert Patterson Individual Corporate DirectorBoard Member Jan 31, 2024
David Martin Individual Corporate DirectorBoard Member May 8, 2025
Peter N Landless Individual Corporate DirectorBoard Member Feb 5, 2025

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 11

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 69

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 69

Affiliated clinicians 913

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 913

NPI Registry JSON

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753747200000",
    "number": "1760764849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933323",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930037",
            "telephone_number": "937-298-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 PENTAGON BLVD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454311705",
            "telephone_number": "937-702-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVERCREEK MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-14",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A",
        "authorized_official_last_name": "KO",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "KETTERING HEALTH CFO",
        "authorized_official_telephone_number": "937-395-8522"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0066896",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soin Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Soin Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.