Individual provider Active NPI

Lila Gwin, M.D.

  • Family Medicine Physician
  • Kettering, OH
National Provider Identifier
1972922375
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.128779 Issued in OH
Practice address
500 Lincoln Park Blvd Ste 220
Kettering, OH 45429-6404
Phone
(937) 294-4487
Fax
(937) 294-2255
NPI assigned
Apr 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.128779 OH Primary

Addresses

Primary practice location

500 Lincoln Park Blvd Ste 220
Kettering, OH 45429-6404

Mailing address

500 Lincoln Park Blvd Ste 220
Kettering, OH 45429-6404
Phone (937) 294-4487

Other identifiers 1

IdentifierTypeStateIssuer
0220813MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lgwin566058@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

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
I20170224001890 OH Practitioner - Family Practice 2769704949 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Carolina at Chapel Hill School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

1 National Rd
Suite 100
Vandalia, OH 45377-2100
Phone (937) 531-0113

1625 S Alex Rd
West Carrollton, OH 45449-5404
Phone (937) 865-0534

Hospital & facility affiliations

  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.128779OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physicians Inc Family Medicine CurrentSince Jul 31, 2017 Accepting new patients
Mvhe Inc CurrentSince Jan 9, 2017 Accepting new patients
Mvhe Inc Family Medicine CurrentSince Jan 9, 2017 Accepting new patients
Alliance Physicians Inc CurrentSince Jul 31, 2017 Accepting new patients

Locations

7740 Washington Village Dr
Ste 130
Dayton, OH 45459
Phone (513) 932-4891

68 Darst Rd
Dayton, OH 45440
Phone (937) 458-6700

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

4441 Far Hills Ave
Kettering, OH 45429
Phone (937) 298-7351

500 Lincoln Park Blvd
Ste 220
Kettering, OH 45429
Phone (937) 294-4487

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

1 E National Rd
Ste 100
Vandalia, OH 45377
Phone (937) 350-6700

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1972922375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LINCOLN PARK BLVD STE 220",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454296404",
            "telephone_number": "937-294-4487",
            "fax_number": "937-294-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LINCOLN PARK BLVD STE 220",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454296404",
            "telephone_number": "937-294-4487",
            "fax_number": "937-294-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWIN",
        "first_name": "LILA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-14",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.128779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0220813",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgwin566058@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "500 Lincoln Park Blvd Ste 220",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454296404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "500 Lincoln Park Blvd Ste 220",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454296404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.