Individual provider Active NPI

Glenn Herman Kluge, M.D.

  • Internal Medicine Physician
  • Dayton, OH
National Provider Identifier
1932157658
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.057549 Issued in OH
Practice address
1320 Woodman Dr
Dayton, OH 45432-3497
Phone
(937) 223-1781
Fax
(937) 853-0096
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.057549 OH Primary

Addresses

Primary practice location

1320 Woodman Dr
Dayton, OH 45432-3497

Mailing address

1320 Woodman Dr
Dayton, OH 45432-3497
Phone (937) 223-1781

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110307000704 OH Practitioner - Internal Medicine 6507948015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.057549OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Theoria Medical Internal Medicine CurrentSince Jun 28, 2024 Accepting new patients
Internal Medicine of Centerville, LLC CurrentSince Sep 20, 2015 Accepting new patients
West Chester Hospital LLC Internal Medicine Past Accepting new patients
University of Cincinnati Medical Center, LLC Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

441 Norton Rd
Columbus, OH 43228
Phone (614) 794-8800

8002 McEwen Rd
Washington Township, OH 45458
Phone (937) 672-8400

1030 High St
Worthington, OH 43085
Phone (614) 876-7356

Organizations & group practices 5

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1932157658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 WOODMAN DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454323497",
            "telephone_number": "937-223-1781",
            "fax_number": "937-853-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WOODMAN DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454323497",
            "telephone_number": "937-223-1781",
            "fax_number": "937-853-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUGE",
        "first_name": "GLENN",
        "middle_name": "HERMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.057549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.