KETTERING CARD AND VAS SURG (NPI# 1881645828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881645828 |
| Entity Type | Organization |
| Organization Name | KETTERING CARD AND VAS SURG |
| Practice Address |
3533 Southern Blvd Ste 5650 Kettering OH 45429-1264 |
| Practice Telephone | 9372943611 |
| Practice Fax Number | 9372949010 |
| Mailing Telephone | 9372943611 |
| Mailing Fax Number | 9372949010 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2014-12-01 |
| Authorized Official Name | KRISTINE M WILSON (PRACTICE MANAGER) |
| Authorized Official Telephone | 9372943694 |
| Authorized Official Credential | CPC, CMPE, CSS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0639867 | 05 |
| Street Address |
3533 SOUTHERN BLVD STE 5650 |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-1264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285630137 | V. Joseph Karnitis | Obstetrics & Gynecology | 3533 Southern Blvd, Suite 4100, Kettering, OH 45429-1264 | 2005-06-24 |
| 1881208346 | Alexander John Armstrong | Physician Assistant | 3533 Southern Blvd, Kettering, OH 45429-1264 | 2020-09-02 |
| 1740739051 | Angela Yost | Nurse Practitioner | 3533 Southern Blvd, Suite 5350, Kettering, OH 45429-1264 | 2016-09-27 |
| 1215385968 | Angela Ponder | Dietitian, Registered | 3533 Southern Blvd, Suite 3750, Kettering, OH 45429-1264 | 2016-06-02 |
| 1992175798 | Megan Haas | Physician Assistant | 3533 Southern Blvd, Suite 5650, Kettering, OH 45429-1264 | 2015-10-06 |
| 1578931564 | Brian Wesche | Nurse Anesthetist, Certified Registered | 3533 Southern Blvd, Suite 3400, Kettering, OH 45429-1264 | 2015-09-08 |
| 1932577012 | Brooke Marie Obrien | Nurse Anesthetist, Certified Registered | 3533 Southern Blvd, Suite 3400, Kettering, OH 45429-1264 | 2015-09-08 |
| 1841682499 | Keith A Rooker | Nurse Anesthetist, Certified Registered | 3533 Southern Blvd, Ste 400, Kettering, OH 45429-1264 | 2015-02-19 |
| 1770972804 | Kristen Roth | Nurse Anesthetist, Certified Registered | 3533 Southern Blvd, Suite 3400, Kettering, OH 45429-1264 | 2015-01-13 |
| 1841600574 | Riyad J Tayim | Surgery | 3533 Southern Blvd, Ste 2250, Kettering, OH 45429-1270 | 2014-05-02 |
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| 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 |
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| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831177872 | Jeffrey Keith Hoffman | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 580 Lincoln Park Blvd, Suite 322, Kettering, OH 45429-3474 | 2006-01-09 |
| 1518249812 | Alliance Physician Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3533 Southern Blvd, Suite 5650, Kettering, OH 45429-1263 | 2011-09-13 |
| 1174578447 | Hans Zwart, M.d. and Associates, Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 580 Lincoln Park Blvd, Suite 322, Kettering, OH 45429-3474 | 2006-05-24 |
| 1487605424 | James P. Campbell, M.d. Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3533 Southern Blvd, Ste 5900, Kettering, OH 45429-1264 | 2006-05-15 |
| 1679551618 | Bruce Henry Rank | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3533 Southern Blvd, Suite 5650, Kettering, OH 45429-1264 | 2006-01-09 |
| 1881692341 | Peter M Pavlina | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3533 Southern Blvd, Ste 5650, Kettering, OH 45429-1264 | 2005-07-08 |
| 1730187469 | Thomas J Merle | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3533 Southern Blvd, Ste 5650, Kettering, OH 45429-1264 | 2005-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003371188 | Christina Marie Babbs | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 48 Executive Dr Ste C, Norwalk, OH 44857-2492 | 2019-02-04 |
| 1265911234 | Andres Jadue | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3312 Aberdeen Rd, Shaker Heights, OH 44120-3328 | 2018-08-10 |
| 1598259863 | Bhalinder Dhaliwal | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Cleveland Clinic 9500, Euclid Avenue/na-23, Cleveland, OH 44195-0001 | 2018-06-19 |
| 1205348307 | Antonio Panza | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Department of Surgery 231 Albert Sabin Way, Cincinnati, OH 45267-0001 | 2017-10-30 |
| 1366972432 | Per Wierup | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 9500 Euclid Ave # Deskj4-1, Cleveland, OH 44195-0001 | 2017-06-12 |
| 1952776247 | Hani Kamal Najm | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 9500 Euclid Ave # M41-02, Cleveland, OH 44195-0001 | 2015-12-11 |
| 1205202967 | Anurag Kaw | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 27020 Cedar Rd Apt 406, Beachwood, OH 44122-1133 | 2015-08-18 |
| 1760872659 | John Albers | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 16 Diplomat Dr, Cincinnati, OH 45215-2073 | 2015-01-29 |
| 1508205048 | Shrey Patel | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 9500 Euclid Ave Ste J4-1, Cleveland, OH 44195-1994 | 2013-06-18 |
| 1457797847 | Charles D. Shook | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 718 Glendale Blvd, Mansfield, OH 44907-2226 | 2013-05-13 |
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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.