Individual provider Active NPI

Carmelite Ruskowski

  • Adult Medicine Physician
  • Kettering, OH
National Provider Identifier
1871238592
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
APRN.CNP.0031226 Issued in OH
Practice address
1050 Forrer Blvd Ste 250
Kettering, OH 45420-3640
Phone
(800) 986-4801
Fax
(937) 684-9990
NPI assigned
Apr 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X APRN.CNP.0031226 OH Primary

Addresses

Primary practice location

1050 Forrer Blvd Ste 250
Kettering, OH 45420-3640

Mailing address

1050 Forrer Blvd Ste 250
Kettering, OH 45420-3640
Phone (800) 986-4801

Other practice location 1

9000 N Main St #403
Dayton, OH 45415
Phone (937) 836-5171

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
I20260324000092 OH Practitioner - Nurse Practitioner 6608350103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mend Health LLCGroup PAC ID 6507205838, 12 clinicians

Practice addresses (Care Compare)

1050 Forrer Blvd
Suite 250
Kettering, OH 45420-3640
Phone (937) 894-1220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0031226OHMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Street Family Practice Inc CurrentSince May 1, 2022 Accepting new patients
Mend Health LLC CurrentSince Feb 23, 2026 Accepting new patients

Locations

9000 N Main St
Ste 403
Englewood, OH 45415
Phone (937) 836-1572

1050 Forrer Blvd
Ste 250
Kettering, OH 45420
Phone (800) 986-4801

1050 Forrer Blvd
#250
Kettering, OH 45420
Phone (937) 894-1220

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.

NPI Registry JSON

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1871238592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 FORRER BLVD STE 250",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454203640",
            "telephone_number": "800-986-4801",
            "fax_number": "937-684-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 FORRER BLVD STE 250",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454203640",
            "telephone_number": "800-986-4801",
            "fax_number": "937-684-9990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9000 N Main St #403",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "45415",
            "country_code": "US",
            "telephone_number": "937-836-5171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSKOWSKI",
        "first_name": "CARMELITE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-28",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "OH",
            "license": "APRN.CNP.0031226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.