Archie D Enoch, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35065803 Issued in OH

Practice address

4172 Indian Ripple Rd Ste a
Beavercreek, OH 45440-3286

Phone

(937) 431-3779

Fax

(937) 431-3776

NPI assigned

Jul 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Wright State University Boonshoft School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kettering Homecare Home health agency, Kettering, OH, CCN 367778
• Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
• Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
• Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
• Kettering Health Greene Memorial Hospital, Xenia, OH, CCN 360026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Alliance Physicians Inc

  dba Kettering Health Medical Group

  • Family Medicine Physician
  • Kettering, OH
  • NPI 1437125572
  Medicare reassignment Care Compare group NPD
• Alliance Physicians Inc

  dba Liberty Pointe Primary Care

  • Family Medicine Physician
  • Miamisburg, OH
  • NPI 1841556727
  NPD
• Knox Clinic Corp

  dba Cottage Orthopedics and Podiatry

  • Durable Medical Equipment & Medical Supplies
  • Galesburg, IL
  • NPI 1669947503
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alternate Solutions Homecare of Dayton, LLC

  • Home Health Agency
  • Kettering, OH
  • NPI 1639195332
  Care Compare affiliation
• Beavercreek Medical Center

  dba Soin Medical Center

  • General Acute Care Hospital
  • Beavercreek, OH
  • NPI 1760764849
  Care Compare affiliation
• Dayton Osteopathic Hospital

  dba Kettering Health Dayton

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1053339507
  Care Compare affiliation
• Greene Memorial Hospital Inc

  dba Kettering Health Greene Memorial

  • General Acute Care Hospital
  • Xenia, OH
  • NPI 1255317848
  Care Compare affiliation
• Kettering Medical Center

  dba Kettering Health Main Campus

  • General Acute Care Hospital
  • Kettering, OH
  • NPI 1043233984
  Care Compare affiliation

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1780683755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4172 INDIAN RIPPLE RD A",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454403286",
            "telephone_number": "937-431-3779",
            "fax_number": "937-431-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4172 INDIAN RIPPLE RD STE A",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454403286",
            "telephone_number": "937-431-3779",
            "fax_number": "937-431-3776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 E Woodbury Dr",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454152855",
            "country_code": "US",
            "telephone_number": "937-277-1722",
            "fax_number": "937-277-8618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENOCH",
        "first_name": "ARCHIE",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35065803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360899251",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0079514",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4172 Indian Ripple Rd Ste A",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454403286",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aenoch517110@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "4172 Indian Ripple Rd Ste A",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454403286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Holly Emsley, OTR/L
• Emx Eye Care PC
• Endoscopy Center of Dayton LTD (Dayton Gastro Endoscopy - Indian Ripple)
• Enginuit Design LTD (Align Home Health)
• Enlightened Therapy Associates, Inc.
• Sarah Eodice
• Jordan Ernst, APRN
• Esthetic Design
• David J Ettinger, MD
• Audra Elizabeth Evans, LMT

• Family Medicine Physician in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.