Dustin Earl Dudley
Individual provider Active NPI Emergency Medicine Physician · Wpafb, OH
NPI 1922686377 · NPPES record last updated Jun 11, 2024
Key facts
- NPI
- 1922686377
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 35.147307 (OH)
- Practice address
- 4881 Sugar Maple Dr
Wpafb, OH 45433-5529 - Phone
- (937) 257-0837
- NPI assigned
- Mar 29, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241126003998 | OH | Practitioner - Emergency Medicine | 6406265818 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.147307 | OH | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miami Valley Emergency Specialists, LLC | Emergency Medicine | Current |
Accepting new patients |
| PHS Emergency Billing LLC | Emergency Medicine | Current |
Accepting new patients |
Locations
8 Oak Park Dr
Bedford, MA 01730
Phone (781) 280-1527
1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636
2400 Miami Valley Dr
Dayton, OH 45459
Phone (937) 208-8394
9000 N Main St
Englewood, OH 45415
Phone (937) 208-8394
4940 Cottonville Rd
Jamestown, OH 45335
Phone (937) 298-4417
300 Austin West Blvd
Miamisburg, OH 45342
Phone (937) 388-7911
1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111
3130 N County Road 25A
Troy, OH 45373
Phone (937) 440-4000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 35.147307 | OH | Yes |
Addresses
Primary practice location
4881 Sugar Maple Dr
Wpafb, OH 45433-5529
Mailing address
4881 Sugar Maple Dr
Wpafb, OH 45433-5529
Other providers in Wpafb, OH
- Stefani Lorane Diedrich
- Docs Health Ohio Inc
- Deborah Downes
- Aaron Jeffery Dramann
- Michael Peter Dring
- Matthew Duenes
- Jennifer E Eby
- Alexander Edwards
- Ashley N Edwards
- George Stephen Edwardson Jr.
All providers in Wpafb, OH · Emergency Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.