NPIMap

Organization Active NPI

Samaritan Family Care Inc

Doing business as Needmore Road Primary Care

  • Family Medicine Physician
  • Dayton, OH
National Provider Identifier
1851627228
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
Needmore Road Primary Care
Practice address
1530 Needmore Rd
Suite 200
Dayton, OH 45414-3969
Phone
(937) 278-5854
Fax
(937) 278-5864
NPI assigned
Oct 20, 2009
Last updated
Nov 8, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
SAMARITAN FAMILY CARE, INCAs 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
President/Ceo
Phone
(937) 208-8213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1530 Needmore Rd
Suite 200
Dayton, OH 45414-3969

Mailing address

1530 Needmore Rd
Suite 200
Dayton, OH 45414-3969
Phone (937) 278-5854

Other identifiers 1

IdentifierTypeStateIssuer
2224597MedicaidOH

Other names 1

  • Needmore Road Primary 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

9000 N Main St
Ste 223
Englewood, OH 45415
Phone (937) 832-9310

9000 N Main St
Ste 233
Englewood, OH 45415
Phone (937) 832-3150

Practitioners & affiliated clinicians

Practitioners 34

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 34

NPI Registry JSON

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383868800000",
    "number": "1851627228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 NEEDMORE RD",
            "address_2": "SUITE 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143969",
            "telephone_number": "937-278-5854",
            "fax_number": "937-278-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 NEEDMORE RD",
            "address_2": "SUITE 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143969",
            "telephone_number": "937-278-5854",
            "fax_number": "937-278-5864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN FAMILY CARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAMARITAN FAMILY CARE, INC",
        "enumeration_date": "2009-10-20",
        "last_updated": "2013-11-08",
        "status": "A",
        "authorized_official_last_name": "PRUNIER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "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": "2224597",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Needmore Road Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 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.