Individual provider Active NPI

Kelly Ann Koenig, PA-C

  • Physician Assistant
  • Dayton, OH
National Provider Identifier
1942746730
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.004960RX Issued in OH
Practice address
1 Childrens PLZ
Dayton, OH 45404-1815
Phone
(937) 641-3600
Fax
(937) 641-5802
NPI assigned
Jan 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.004960RX OH Primary

Addresses

Primary practice location

1 Childrens PLZ
Dayton, OH 45404-1815

Mailing address

PO Box 933432
Cleveland, OH 44193-0039
Phone (937) 641-3000

Other practice location 1

8501 Old Troy Pike
Huber Heights, OH 45424-1054
Phone (937) 641-4360

Other practice location 2

3301 Dayton Xenia Rd Ste 200
Beavercreek, OH 45432-2759
Phone (937) 641-5098

Other practice location 3

7787 Cox Ln
West Chester, OH 45069-6549
Phone (513) 644-8081

Other practice location 4

1711 Germantown Pike
Dayton, OH 45417
Phone (937) 641-3142

Other practice location 5

4475 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 641-3141

Other practice location 6

860 Valley St.
Dayton, OH 45404
Phone (937) 641-3060

Other practice location 7

6655 Corkwood Knl
Hamilton, OH 45011-8533
Phone (513) 673-1578

Other practice location 8

792 Northwoods Blvd
Vandalia, OH 45377-9462
Phone (937) 641-4236

Other practice location 9

3333 W Tech Rd
Miamisburg, OH 45342-0955
Phone (937) 641-3400

Other practice location 10

3333 W Tech Rd
Miamisburg, OH 45342-0955
Phone (937) 641-3400

Other practice location 11

6044 Wilmington Pike
Dayton, OH 45459-7006
Phone (937) 641-3270

Other practice location 12

662 N Main St
Springboro, OH 45066-9553
Phone (937) 641-5066

Other identifiers 1

IdentifierTypeStateIssuer
0215468MedicaidOH

Other names 1

  • Kelly Ann Morris Former name

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
I20170425000805 OH Practitioner - Physician Assistant 7315223591 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.004960RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Children'S Hospital Physician Assistant CurrentSince Sep 1, 2024 Accepting new patients
Dayton Children'S Specialty Physicians, Inc. Physician Assistant CurrentSince Jan 14, 2024 Accepting new patients

Locations

3301 Dayton Xenia Rd
Ste 200
Beavercreek, OH 45432
Phone (937) 641-5098

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

860 Valley St
Dayton, OH 45404
Phone (937) 641-3060

6044 Wilmington Pike
Dayton, OH 45459
Phone (937) 641-3270

1711 Germantown St
Dayton, OH 45417
Phone (937) 641-3142

8501 Old Troy Pike
Huber Heights, OH 45424
Phone (937) 233-1095

4475 Far Hills Ave
Kettering, OH 45429
Phone (937) 641-3141

967 Bellefontaine Ave
Lima, OH 45804
Phone (419) 224-1330

8809 Wilkens Blvd
Mason, OH 45040
Phone (513) 701-6907

3333 W Tech Rd
Miamisburg, OH 45342
Phone (937) 641-3400

662 N Main St
Springboro, OH 45066
Phone (937) 641-5066

792 Northwoods Blvd
Vandalia, OH 45377
Phone (937) 641-4236

7787 Cox Ln
West Chester, OH 45069
Phone (513) 644-8081

Organizations & group practices 3

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": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1942746730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933432",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041815",
            "telephone_number": "937-641-3600",
            "fax_number": "937-641-5802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8501 Old Troy Pike",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241054",
            "country_code": "US",
            "telephone_number": "937-641-4360",
            "fax_number": "937-641-3791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3301 Dayton Xenia Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454322759",
            "country_code": "US",
            "telephone_number": "937-641-5098",
            "fax_number": "937-912-9395",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7787 Cox Ln",
            "address_purpose": "LOCATION",
            "city": "West Chester",
            "state": "OH",
            "postal_code": "450696549",
            "country_code": "US",
            "telephone_number": "513-644-8081",
            "fax_number": "513-847-1192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1711 Germantown Pike",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "45417",
            "country_code": "US",
            "telephone_number": "937-641-3142",
            "fax_number": "937-641-4172",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4475 Far Hills Ave",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454292405",
            "country_code": "US",
            "telephone_number": "937-641-3141",
            "fax_number": "937-641-3190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "860 Valley St.",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "45404",
            "country_code": "US",
            "telephone_number": "937-641-3060",
            "fax_number": "937-641-3285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6655 Corkwood Knl",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "OH",
            "postal_code": "450118533",
            "country_code": "US",
            "telephone_number": "513-673-1578",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "792 Northwoods Blvd",
            "address_purpose": "LOCATION",
            "city": "Vandalia",
            "state": "OH",
            "postal_code": "453779462",
            "country_code": "US",
            "telephone_number": "937-641-4236",
            "fax_number": "937-641-4237",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 W Tech Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420955",
            "country_code": "US",
            "telephone_number": "937-641-3400",
            "fax_number": "937-641-4880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 W Tech Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420955",
            "country_code": "US",
            "telephone_number": "937-641-3400",
            "fax_number": "937-641-4880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6044 Wilmington Pike",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454597006",
            "country_code": "US",
            "telephone_number": "937-641-3270",
            "fax_number": "937-641-6108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "662 N Main St",
            "address_purpose": "LOCATION",
            "city": "Springboro",
            "state": "OH",
            "postal_code": "450669553",
            "country_code": "US",
            "telephone_number": "937-641-5066",
            "fax_number": "937-550-9797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-17",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004960RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0215468",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MORRIS",
            "middle_name": "ANN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.