NPIMap

Organization Active NPI

Beavercreek Medical Center

Doing business as Kettering Health Primary Care, A Service of Soin Medical Center

  • Rural Health Clinic/Center
  • Cedarville, OH
National Provider Identifier
1821959560
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BEAVERCREEK MEDICAL CENTER
Doing business as
Kettering Health Primary Care, A Service of Soin Medical Center
Practice address
29 Kyle Dr
Cedarville, OH 45314-9580
Phone
(937) 766-2611
NPI assigned
Nov 21, 2025
Last updated
Nov 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

29 Kyle Dr
Cedarville, OH 45314-9580

Mailing address

PO Box 933323
Cleveland, OH 44193-0037

Other names 1

  • Kettering Health Primary Care, A Service of Soin Medical Center Doing business as

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.

NPI Registry JSON

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

{
    "created_epoch": "1763683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763683200000",
    "number": "1821959560",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 KYLE DR",
            "city": "CEDARVILLE",
            "state": "OH",
            "postal_code": "453149580",
            "telephone_number": "937-766-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVERCREEK MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-21",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A",
        "authorized_official_last_name": "KO",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "KETTERING HEALTH CFO",
        "authorized_official_telephone_number": "937-395-8522"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kettering Health Primary Care, A Service of Soin Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedarville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; 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.