Kettering Card and Vas Surg

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

Legal business name

KETTERING CARD AND VAS SURG

Practice address

3533 Southern Blvd
Ste 5650
Kettering, OH 45429-1264

Phone

(937) 294-3611

Fax

(937) 294-9010

NPI assigned

May 15, 2006

Organization subpart

No

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

Authorized official

Name

Kristine M Wilson, CPC, CMPE, CSS

Title

Practice Manager

Phone

(937) 294-3694

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417392000000",
    "number": "1881645828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 SOUTHERN BLVD",
            "address_2": "STE 5650",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291264",
            "telephone_number": "937-294-3611",
            "fax_number": "937-294-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 SOUTHERN BLVD",
            "address_2": "STE 5650",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291264",
            "telephone_number": "937-294-3611",
            "fax_number": "937-294-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETTERING CARD AND VAS SURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2014-12-01",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "937-294-3694",
        "authorized_official_credential": "CPC, CMPE, CSS"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0639867",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johnna K Kern, DO
• Kasindra Nicole Kerns, MS, PC
• Stephanie S. Kerr, CDA
• Kettering Affiliated Health Services
• Kettering Anesthesia Associates, Inc
• Kettering Cardiothoracic and Vascular Surgeons, Inc
• Kettering Chiropractic Center Inc
• Kettering City School District
• Kettering Health Network
• Kettering Independent Medical Group Inc

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Kettering, OH
• Providers in Kettering, OH by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; 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.