| Charles Drew Health Center | |
|
1323 W 3rd St Dayton OH 45402-6714 | |
| (937) 586-9733 | |
| (937) 461-9698 |
| Full Name | Charles Drew Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1323 W 3rd St, Dayton, Ohio |
| Authorized Official Name and Position | Gregory Hopkins (CEO) |
| Authorized Official Contact | 9375869733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Drew Health Center 1323 W 3rd St Dayton OH 45402-6714 Ph: (937) 586-9733 | Charles Drew Health Center 1323 W 3rd St Dayton OH 45402-6714 Ph: (937) 586-9733 |
| NPI Number | 1013197003 |
|---|---|
| Provider Enumeration Date | 11/07/2007 |
| Last Update Date | 12/21/2021 |
| Medicare PECOS PAC ID | 7012094386 |
|---|---|
| Medicare Enrollment ID | O20080410000531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013197003 | NPI | - | NPPES |
| 2986881 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Ohio) | Primary |
| Provider Name | Ladonna Jean Barnes-lark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477577419 PECOS PAC ID: 6406933704 Enrollment ID: I20080410000806 |
| Provider Name | Gary Lewis Leroy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588603724 PECOS PAC ID: 7416980982 Enrollment ID: I20080506000679 |
| Provider Name | Suzann Franer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477534006 PECOS PAC ID: 4385723063 Enrollment ID: I20080506000697 |
| Provider Name | Michele A Hanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184925810 PECOS PAC ID: 7517147333 Enrollment ID: I20110211000280 |
| Provider Name | Teresa Menart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285622084 PECOS PAC ID: 9032376942 Enrollment ID: I20120204000023 |
| Provider Name | Emily D Treffinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992013700 PECOS PAC ID: 4486803285 Enrollment ID: I20121011000813 |
| Provider Name | Adrienne W Lee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639340136 PECOS PAC ID: 3577752625 Enrollment ID: I20130627000803 |
| Provider Name | Cherise A Varner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821414830 PECOS PAC ID: 5294958971 Enrollment ID: I20140527001841 |
| Provider Name | Kimberly L Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639589773 PECOS PAC ID: 7719101732 Enrollment ID: I20140613001315 |
| Provider Name | Anna L Roetker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073554408 PECOS PAC ID: 6800876806 Enrollment ID: I20150122000498 |
| Provider Name | Amanda M Maroon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720481914 PECOS PAC ID: 3971820671 Enrollment ID: I20150317001979 |
| Provider Name | Timothy Zigler |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1598014037 PECOS PAC ID: 6002122900 Enrollment ID: I20150908001464 |
| Provider Name | Emily H Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538644935 PECOS PAC ID: 0345584587 Enrollment ID: I20181129001043 |
| Provider Name | Nancy Louise Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770095382 PECOS PAC ID: 5597020065 Enrollment ID: I20181226001906 |
| Provider Name | Angela Kay Kaffenbarger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477093623 PECOS PAC ID: 8123459625 Enrollment ID: I20200518001809 |
| Provider Name | Donna Beaven |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235222373 PECOS PAC ID: 0042283871 Enrollment ID: I20210624003750 |
| Provider Name | Bethany Rose Galati |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790244432 PECOS PAC ID: 0446583264 Enrollment ID: I20220725003457 |
| Provider Name | Debra Bowling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326517947 PECOS PAC ID: 3476899378 Enrollment ID: I20231103002802 |
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