NPIMap

Organization Active NPI

Samaritan Family Care, Inc.

Doing business as Brookville Family Care

  • Family Medicine Physician
  • Brookville, OH
National Provider Identifier
1851344501
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAMARITAN FAMILY CARE, INC.
Doing business as
Brookville Family Care
Practice address
950 Salem St
Brookville, OH 45309-8227
Phone
(937) 833-4581
Fax
(937) 833-5359
NPI assigned
May 17, 2006
Last updated
Nov 8, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
SAMARITAN FAMILY CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Authorized official

Name
Kenneth Prunier
Title
Ceo/President
Phone
(937) 208-8213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

950 Salem St
Brookville, OH 45309-8227

Mailing address

950 Salem St
Brookville, OH 45309-8227
Phone (937) 833-4581

Other identifiers 1

IdentifierTypeStateIssuer
0224537MedicaidOH

Other names 1

  • Brookville Family Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040203000210 OH Part B Supplier - Clinic/Group Practice 5092608372 Receives reassigned benefits from 160 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Englewood, OH; Vandalia, OH; New Lebanon, OH; Lewisburg, OH; Huber Heights, OH; Dayton, OH; Brookville, OH

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory
Part of
Primary Care Physicians

Locations

1530 Needmore Rd
Ste 200
Dayton, OH 45414
Phone (937) 278-5854

2661 Salem Ave
Dayton, OH 45406

6251 Miami Valley Way
Ste 120A
Dayton, OH 45424

6251 Miami Valley Way
Ste 210B
Dayton, OH 45424

9000 N Main St
Ste 239
Englewood, OH 45415
Phone (937) 898-1566

9000 N Main St
Ste G-35
Englewood, OH 45415
Phone (937) 276-8320

9000 N Main St
Ste G33
Englewood, OH 45415
Phone (937) 208-5300

804 Central Ave
Greenville, OH 45331
Phone (937) 547-0107

220 E Main St
New Lebanon, OH 45345
Phone (937) 687-1331

600 Aviator Ct
Ste 600
Vandalia, OH 45377

810 Falls Creek Dr
#B
Vandalia, OH 45377
Phone (937) 298-2584

Practitioners & affiliated clinicians

Practitioners 85

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 85

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383868800000",
    "number": "1851344501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 SALEM ST",
            "city": "BROOKVILLE",
            "state": "OH",
            "postal_code": "453098227",
            "telephone_number": "937-833-4581",
            "fax_number": "937-833-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 SALEM ST",
            "city": "BROOKVILLE",
            "state": "OH",
            "postal_code": "453098227",
            "telephone_number": "937-833-4581",
            "fax_number": "937-833-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN FAMILY CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAMARITAN FAMILY CARE, INC.",
        "enumeration_date": "2006-05-17",
        "last_updated": "2013-11-08",
        "status": "A",
        "authorized_official_last_name": "PRUNIER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "937-208-8213"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0224537",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookville Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.