ALLIANCE PHYSICIAN INC (NPI# 1891077293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1891077293 |
Entity Type | Organization |
Organization Name | ALLIANCE PHYSICIAN INC |
Other Organization Name | KETTERING MEDICAL CENTER - BREAST EVALUATION CENTER |
Practice Address |
3535 Southern Blvd Suite B Kettering OH 45429-1221 |
Mailing Address |
2110 Leiter Rd Miamisburg OH 45342-3660 |
Practice Telephone | 9372984331 |
Mailing Telephone | 9373844838 |
Mailing Fax Number | 9373844845 |
Enumeration Date | 2011-09-13 |
Last Update Date | 2011-09-13 |
Authorized Official Name | DANIEL D HAIBACH (DIRECTOR BUSINESS DEVELOPMENT) |
Authorized Official Telephone | 9379147094 |
Is Organization Subpart | Y |
Parent Organization Name | ALLIANCE PHYSICIAN INC |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OH | 2712872 | 05 |
Other Name | Type Code |
---|---|
Kettering Medical Center - Breast Evaluation Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821160243 | Alliance Physician Inc | Family Medicine | 4403 Far Hills Ave, Kettering, OH 45429-2405 | 2006-11-14 |
1891077194 | Alliance Physician Inc | Neurological Surgery | 3533 Southern Blvd, Suite 5350, Kettering, OH 45429-1263 | 2011-09-13 |
1285916585 | Alliance Physician Inc | Psychiatry & Neurology | 3533 Southern Blvd, Suite 5200, Kettering, OH 45429-1275 | 2011-09-13 |
1598047813 | Alliance Physician Inc | Orthopaedic Surgery | 2350 Miami Valley Dr, Suite 320, Centerville, OH 45459-4000 | 2011-09-13 |
1275815672 | Alliance Physician Inc | Internal Medicine | 3737 Southern Blvd, Suite 3200, Kettering, OH 45429-1286 | 2011-09-13 |
1710269113 | Alliance Physician Inc | Obstetrics & Gynecology | 3737 Southern Blvd, Suite 3100, Kettering, OH 45429-1286 | 2011-09-13 |
1669754065 | Alliance Physician Inc | Physician Assistant | 405 W Grand Ave, Or Dept, Dayton, OH 45405-4720 | 2011-09-13 |
1104108406 | Alliance Physician Inc | Surgery | 1 Elizabeth Pl, Suite 10a-1, Dayton, OH 45417-3445 | 2011-09-13 |
1629350020 | Alliance Physician Inc | Surgery | 3737 Southern Blvd, Suite 2000a, Kettering, OH 45429-1262 | 2011-09-13 |
1679855985 | Alliance Physician Inc | Urology | 7756 Washington Village Dr, Suite 135, Centerville, OH 45459-3953 | 2011-09-13 |
Street Address |
3535 SOUTHERN BLVD SUITE B |
City | KETTERING |
State | OH |
Zip Code | 45429-1221 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134124183 | David M Brouhard | Anesthesiology | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2005-06-16 |
1245846757 | Rachel Henderson | Pharmacist | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-09-21 |
1235745043 | Nipa Mukesh Patel | Pharmacist | 3535 Southern Blvd, Kettering, OH 45429-1298 | 2020-09-17 |
1104437425 | Stephanie Elizabeth Nicholls | Hospitalist | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-08-11 |
1346865144 | Anesthesia Pearls, LLC | Nurse Anesthetist, Certified Registered | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-06-08 |
1568087351 | Pearl Lee | Nurse Anesthetist, Certified Registered | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-06-08 |
1922631761 | Michael Patrick Lorey | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-02-20 |
1801446315 | Madison A Tate | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-09-17 |
1962058966 | Joshua Caleb Courlas | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-08-15 |
1134775273 | Jason Raymond Leigh | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-08-14 |
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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 |
Find all providers in zip 45429 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497902944 | Jennifer Roberts | Physician Assistant | 3533 Southern Blvd Ste 5650, Kettering, OH 45429-1263 | 2008-08-26 |
1992175798 | Megan Haas | Physician Assistant | 3533 Southern Blvd, Suite 5650, Kettering, OH 45429-1264 | 2015-10-06 |
1881096311 | Brennan L Kelly | Physician Assistant | 3700 Southern Blvd Ste 300, Kettering, OH 45429-1226 | 2014-09-16 |
1467781310 | Ericka Lynn Mcconnaughey | Physician Assistant | 3533 Southern Blvd, Ste 3000, Kettering, OH 45429-1280 | 2009-12-23 |
1689798662 | Jason R Roller | Physician Assistant | 3533 Southern Blvd, Ste 2100, Kettering, OH 45429-1267 | 2007-03-16 |
1568460236 | Michael Rumschik | Physician Assistant | 3533 Southern Blvd, Ste 5650, Kettering, OH 45429-1264 | 2005-07-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508418260 | Collin Dees | Physician Assistant | Tripoint Medical Center, 7590 Auburn Road, Painesville, OH 44077 | 2019-07-12 |
1811469968 | Cody Tyler Delaney | Physician Assistant | 1711 27th St Ste 306, Portsmouth, OH 45662-2669 | 2018-12-28 |
1861936155 | Surgical Fusion, LLC | Physician Assistant | 605 N High St # 237, Columbus, OH 43215-2024 | 2016-12-06 |
1225481690 | Rebekah Keesee | Physician Assistant | 1045 Arundel Ave, Westerville, OH 43081-1188 | 2016-07-20 |
1568814382 | Kristen Cipolla | Physician Assistant | 1049 Scarlet Oak Dr Apt D, Hudson, OH 44236-4542 | 2016-07-05 |
1932560083 | Adam Peckinpaugh | Physician Assistant | 2109 Hughes Drive #450, Jobst Vascular Institute, Toledo, OH 43606-5102 | 2016-03-17 |
1710348701 | Alex Blake | Physician Assistant | 10743 S State Route 133, Blanchester, OH 45107-9435 | 2016-03-17 |
1215319926 | Richard Alan Stevenson | Physician Assistant | 187 Vine St, Fairborn, OH 45324-3324 | 2015-06-18 |
1548641038 | Matthew Hamley | Physician Assistant | 2315 Birch Trace Dr, Youngstown, OH 44515-4914 | 2015-06-10 |
1588094148 | Kevin W. Rotondo | Physician Assistant | 1732 Maple St, Wickliffe, OH 44092-2423 | 2013-11-19 |
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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.