Kesley Peterson, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

34.017928 Issued in OH

Practice address

3535 Southern Blvd
Kettering, OH 45429-1221

Phone

(937) 395-8166

NPI assigned

Mar 30, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1871233585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 NEWMARK DR STE 220",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453425400",
            "telephone_number": "937-438-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-395-8166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1997 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454593811",
            "country_code": "US",
            "telephone_number": "937-401-6228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 Washington Jackson Rd",
            "address_purpose": "LOCATION",
            "city": "Eaton",
            "state": "OH",
            "postal_code": "453208699",
            "country_code": "US",
            "telephone_number": "937-456-8376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453427615",
            "country_code": "US",
            "telephone_number": "937-384-8791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6147 State Route 122",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450055201",
            "country_code": "US",
            "telephone_number": "513-261-3410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2300 N Limestone St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OH",
            "postal_code": "455031102",
            "country_code": "US",
            "telephone_number": "937-504-8305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Pentagon Blvd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454311705",
            "country_code": "US",
            "telephone_number": "937-702-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1141 N Monroe Dr",
            "address_purpose": "LOCATION",
            "city": "Xenia",
            "state": "OH",
            "postal_code": "453851619",
            "country_code": "US",
            "telephone_number": "937-352-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 W Main St",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "OH",
            "postal_code": "453733384",
            "country_code": "US",
            "telephone_number": "937-980-7010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454057538",
            "country_code": "US",
            "telephone_number": "937-723-3211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8701 Old Troy Pike",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241066",
            "country_code": "US",
            "telephone_number": "937-558-3338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Kettering Way",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "OH",
            "postal_code": "450051155",
            "country_code": "US",
            "telephone_number": "937-458-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KESLEY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.017928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackie Renea' Perry, LPN
• Sue E Perry, CRNA
• Robin Stubbs Peter, OT
• Darla C Peters
• Charles D Peterson, MD
• Mikhail Petrov
• Taylor Petry, M.S. CCC-SLP
• John Petty, MD
• Carrie A Phillips, LISW
• Myah Phillips

• Emergency Medicine Physician in Kettering, OH
• Providers in Kettering, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.