PREMIER INTEGRATED MEDICAL ASSOCIATES, LTD (NPI# 1043277437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043277437 |
| Entity Type | Organization |
| Organization Name | PREMIER INTEGRATED MEDICAL ASSOCIATES, LTD |
| Other Organization Name | PRIMED PHYSICIANS |
| Practice Address |
540 Lincoln Park Blvd Suite 200 Kettering OH 45429-6401 |
| Mailing Address |
25 Merchant St Ste 220 - Attn Credentialing Cincinnati OH 45246-3740 |
| Practice Telephone | 9372988058 |
| Practice Fax Number | 9372985638 |
| Mailing Telephone | 5135331199 |
| Mailing Fax Number | 5136459827 |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2019-04-26 |
| Authorized Official Name | DR. MARK A COUCH (PRESIDENT) |
| Authorized Official Telephone | 9378983600 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 3005198 | 05 |
| Other Name | Type Code |
|---|---|
| PriMed Physicians | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710944053 | Premier Integrated Medical Associates, Ltd | Clinical Medical Laboratory | 948 Patterson Rd, Dayton, OH 45419-4336 | 2006-04-28 |
| 1457317679 | Premier Integrated Medical Associates, Ltd | Family Medicine | 1 E National Rd, Vandalia, OH 45377-2116 | 2006-04-25 |
| 1790749307 | Premier Integrated Medical Associates, Ltd | Pediatrics | 120 W Wenger Rd, Englewood, OH 45322-2762 | 2006-04-12 |
| Street Address |
540 LINCOLN PARK BLVD SUITE 200 |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-6401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215933387 | Reginald Sequeira | Internal Medicine | 540 Lincoln Park Blvd, Suite 200, Kettering, OH 45429-6401 | 2005-06-23 |
| 1801312616 | Denisa Despina Jacobs | Radiologic Technologist | 540 Lincoln Park Blvd, Kettering, OH 45429-6401 | 2017-08-15 |
| 1356364145 | John Lynch IIi | Internal Medicine | 540 Lincoln Park Blvd, Suite 200, Kettering, OH 45429-6401 | 2006-07-25 |
| 1558383141 | Connie Sue Bain | Physical Therapist | 540 Lincoln Park Blvd, Suite 350, Kettering, OH 45429-6401 | 2006-07-24 |
| 1417976192 | Robert Matthew Lemming | Radiology | 540 Lincoln Park Blvd, Suite 100, Kettering, OH 45429-6401 | 2006-07-19 |
| 1275552952 | Sharal Mall | Radiology | 540 Lincoln Park Blvd, Suite 100, Kettering, OH 45429-6401 | 2006-07-19 |
| 1720037534 | Kettering Radiologist Imaging Center | Radiology | 540 Lincoln Park Blvd, Suite 100, Kettering, OH 45429-6401 | 2006-05-09 |
| 1811946932 | Gilbert W. Templeton | Internal Medicine | 540 Lincoln Park Blvd, Suite 200, Kettering, OH 45429-6401 | 2006-05-08 |
| 1356399489 | Premier Integrated Medical Assoc. Ltd. | Physical Therapist | 540 Lincoln Park Blvd, Suite350, Kettering, OH 45429-6401 | 2006-05-04 |
| 1750349551 | Premier Integrated Medical Assoc Ltd | Internal Medicine | 540 Lincoln Park Blvd, Suite 200, Kettering, OH 45429-6401 | 2006-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821576414 | Lauren Danielle Sivley | Nurse Practitioner | 3535 Sourthern Boulevard, Kettering, OH 45429 | 2018-08-06 |
| 1114446127 | Louai Al-samkari | Chiropractor | 1441 E. Stroop Rd., Kettering, OH 45429 | 2017-09-12 |
| 1407373756 | Benjamin Edward Adkins | Specialist/Technologist | 4116 Vinita Dr., Kettering, OH 45429 | 2017-08-28 |
| 1972036341 | James Kim | Student in an Organized Health Care Education/Training Program | 3535 Southern Boulevard, Kettering, OH 45429 | 2017-04-04 |
| 1023549847 | Adrienne Krysiak | Emergency Medicine | 3525 Southern Boulevard, Kettering, OH 45429 | 2017-03-23 |
| 1386021889 | Cassandra Mckoy | Counselor | 529 East Stroop Road, Kettering, OH 45429 | 2015-05-04 |
| 1417343088 | Candace Benoit | Obstetrics & Gynecology | 3533 Southern Blvd Ste 4600, Dayton, OH 45429 | 2015-04-10 |
| 1275933574 | Lee Schwieterman | Nurse Practitioner | 3535 Southern Blvd., 1 East, Kettering, OH 45429 | 2014-08-25 |
| 1497161947 | Robert Jonathon Fresch Jr. | Obstetrics & Gynecology | 3533 Southern Blvd Ste 3750, Kettering, OH 45429 | 2014-07-05 |
| 1821349812 | Lucas Brewer | Counselor | 1524 E Stroop Rd Ste 300, Kettering, OH 45429 | 2012-10-01 |
| Find all providers in zip 45429 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063494086 | Ajay Reddivari | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2005-11-16 |
| 1215933387 | Reginald Sequeira | Internal Medicine | 540 Lincoln Park Blvd, Suite 200, Kettering, OH 45429-6401 | 2005-06-23 |
| 1720106685 | Nathaniel Joseph Dittoe | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2007-03-27 |
| 1720111487 | Schuster Cardiology Associates, Inc. | Internal Medicine | 3533 Southern Blvd, Suite 3550, Kettering, OH 45429-1264 | 2007-03-13 |
| 1750432811 | Cardiology South | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2007-01-16 |
| 1356364145 | John Lynch IIi | Internal Medicine | 540 Lincoln Park Blvd, Suite 200, Kettering, OH 45429-6401 | 2006-07-25 |
| 1306864608 | Mark W Moronell | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429 | 2006-07-17 |
| 1164452645 | Southwest Cardiology Inc | Internal Medicine | 3533 Southern Blvd, Suite 2100, Kettering, OH 45429-1267 | 2006-07-03 |
| 1669456943 | Robert Woodrow Kiefaber | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2005-12-01 |
| 1811971039 | Harvey Sungha Hahn | Internal Medicine | 3533 Southern Blvd, Suite 2100, Kettering, OH 45429-1264 | 2005-12-01 |
| Find all providers in KETTERING | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.