Providence Medical Group is a
Podiatrist based in Moraine, Ohio. Providence Medical Group is licensed to practice in Ohio (license number 36.003657) and their current practice location is
2912 Springboro Rd, Suite 201, Moraine, Ohio. It can be reached at their office (for appointments etc.) via phone at
(937) 297-8999.
NPI number for Providence Medical Group is 1811304595 and their current mailing address is 2912 Springboro Rd, Suite 201, Moraine, Ohio. Providence Medical Group
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1811304595.
Healthcare Provider's Profile
Full Name | Providence Medical Group |
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Type | Facility |
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Speciality | Podiatrist |
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Location | 2912 Springboro Rd, Moraine, Ohio |
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Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
NPI Data:
- NPI Number: 1811304595
- Provider Enumeration Date: 07/15/2014
- Last Update Date: 10/28/2014
Medical Identifiers
Medical identifiers for Providence Medical Group such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1811304595 | NPI | - | NPPES |
1285952937 | Other | OH | INDIVIDUAL NPI |
2380294 | Medicaid | OH | |
0083030 | Medicaid | OH | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
213E00000X | Podiatrist | 36.003657 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Providence Medical Group is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Providence Medical Group 2912 Springboro Rd, Suite 201, Moraine, OH 45439-1674 Ph: (937) 297-8999 | Providence Medical Group 2912 Springboro Rd, Suite 201, Moraine, OH 45439-1674 Ph: (937) 297-8999 |
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