Individual provider Active NPI

Lori Ann Zwickel, PA-C

  • Medical Physician Assistant
  • Centerville, OH
National Provider Identifier
1821379025
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50.003379 Issued in OH
Practice address
6661 Clyo Rd
Centerville, OH 45459-2767
Phone
(937) 425-4000
Fax
(937) 425-4002
NPI assigned
Aug 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50003379 OH
Medical Physician Assistant 363AM0700X 50.003379 OH Primary

Addresses

Primary practice location

6661 Clyo Rd
Centerville, OH 45459-2767

Mailing address

6661 Clyo Rd
Centerville, OH 45459-2767
Phone (937) 425-4000

Other identifiers 2

IdentifierTypeStateIssuer
50003379OtherOHOHIO LICENSE
0075601MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lzwickel465750@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

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
I20111012000733 OH Practitioner - Physician Assistant 5799957908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
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)

1625 S Alex Rd
West Carrollton, OH 45449-5404
Phone (937) 865-0534

Hospital & facility affiliations

  • Kettering Homecare Home health agency, Kettering, OH, CCN 367778
  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
  • Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239
  • Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
  • Kettering Health Greene Memorial Hospital, Xenia, OH, CCN 360026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50003379OHMDPhysician Assistant
50.003379OHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physicians Inc CurrentSince Sep 19, 2011 Accepting new patients
Alliance Physicians Inc CurrentSince Sep 19, 2011 Accepting new patients

Locations

7740 Washington Village Dr
Ste 130
Dayton, OH 45459
Phone (513) 932-4891

6661 Clyo Rd
Dayton, OH 45459
Phone (937) 425-4000

3095 Dayton Xenia Rd
Ste 100
Dayton, OH 45434
Phone (937) 531-7902

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342
Phone (937) 384-8791

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1821379025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6661 CLYO RD",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592767",
            "telephone_number": "937-425-4000",
            "fax_number": "937-425-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6661 CLYO RD",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592767",
            "telephone_number": "937-425-4000",
            "fax_number": "937-425-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZWICKEL",
        "first_name": "LORI",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50003379",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.003379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO LICENSE",
            "identifier": "50003379",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0075601",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lzwickel465750@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "6661 Clyo Rd",
            "city": "Centerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454592767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6661 Clyo Rd",
            "city": "Centerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454592767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

Verify at the official NPI Registry.