Organization Active NPI

The Kingdom Wellness Group

  • Family Medicine Physician
  • Dayton, OH
National Provider Identifier
1801754684
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
THE KINGDOM WELLNESS GROUP
Practice address
6148 Little Creek CT
Dayton, OH 45424-1321
Phone
(313) 810-2948
NPI assigned
Jan 12, 2026
Last updated
Jan 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Authorized official

Name
Deshawn Harris, NURSE PRACTITIONERNPI 1558503615
Title
Provider
Phone
(313) 810-2948

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

6148 Little Creek CT
Dayton, OH 45424-1321

Mailing address

6148 Little Creek CT
Dayton, OH 45424-1321
Phone (313) 810-2948

Other practice location 1

4769 Free Pike
Trotwood, OH 45416-1111
Phone (313) 810-2948

National Provider Directory

National Provider Directory

Locations

4769 Free Pike
Trotwood, OH 45416
Phone (313) 810-2948

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1768176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768176000000",
    "number": "1801754684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6148 LITTLE CREEK CT",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454241321",
            "telephone_number": "313-810-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6148 LITTLE CREEK CT",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454241321",
            "telephone_number": "313-810-2948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4769 Free Pike",
            "address_purpose": "LOCATION",
            "city": "Trotwood",
            "state": "OH",
            "postal_code": "454161111",
            "country_code": "US",
            "telephone_number": "313-810-2948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE KINGDOM WELLNESS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-12",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "DESHAWN",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "313-810-2948",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; 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.