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1152 W 3rd St Dayton OH 45402-6812 | |
| (937) 268-3483 | |
| (937) 268-1884 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 1152 W 3rd St, Dayton, Ohio |
| Authorized Official Name and Position | Mark A Couch (PRESIDENT) |
| Authorized Official Contact | 9378983600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
25 Merchant St Ste 220 - Attn Credentialing Cincinnati OH 45246-3740 Ph: (513) 533-1199 | 1152 W 3rd St Dayton OH 45402-6812 Ph: (937) 268-3483 |
| NPI Number | 1811953052 |
|---|---|
| Provider Enumeration Date | 04/25/2006 |
| Last Update Date | 07/15/2019 |
| Medicare PECOS PAC ID | 9032101399 |
|---|---|
| Medicare Enrollment ID | O20040409000393 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811953052 | NPI | - | NPPES |
| CA2478 | Other | MEDICARE RR GROUP NUMBER | |
| 2121948 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Mark Regan Schloneger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598720393 PECOS PAC ID: 6608868161 Enrollment ID: I20040402000504 |
| Provider Name | Thomas C Greer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295799054 PECOS PAC ID: 9234125683 Enrollment ID: I20040422000096 |
| Provider Name | Thomas W Hirt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174580187 PECOS PAC ID: 5890774574 Enrollment ID: I20040715001462 |
| Provider Name | Janette Reid Froehlich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922063973 PECOS PAC ID: 0244208601 Enrollment ID: I20040922001284 |
| Provider Name | Marlon D Twyman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336104009 PECOS PAC ID: 5799715439 Enrollment ID: I20050812000820 |
| Provider Name | Claire Nicole Mcdowell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124030689 PECOS PAC ID: 9638174022 Enrollment ID: I20060918000274 |
| Provider Name | Ling Xu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255356069 PECOS PAC ID: 7810992641 Enrollment ID: I20060928000412 |
| Provider Name | Mark A Couch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548224314 PECOS PAC ID: 1153315429 Enrollment ID: I20100317000167 |
| Provider Name | James F Seiler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548224504 PECOS PAC ID: 5698762607 Enrollment ID: I20100317000235 |
| Provider Name | William J Randall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851355630 PECOS PAC ID: 2567597420 Enrollment ID: I20100317000294 |
| Provider Name | Rachel Elizabeth Sidwell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063642643 PECOS PAC ID: 6305039314 Enrollment ID: I20130221000350 |
| Provider Name | Julie D Haver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427490770 PECOS PAC ID: 0840433728 Enrollment ID: I20130823001299 |
| Provider Name | Brandon J Bell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669683090 PECOS PAC ID: 9931285871 Enrollment ID: I20131113001594 |
| Provider Name | Michael A Witt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154373199 PECOS PAC ID: 0345274650 Enrollment ID: I20140226002039 |
| Provider Name | Andrea Ruth Dillon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316207889 PECOS PAC ID: 0143457820 Enrollment ID: I20150622002546 |
| Provider Name | Amanda Elizabeth Gedeit |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154760999 PECOS PAC ID: 1052541398 Enrollment ID: I20160802003290 |
| Provider Name | Randy Earl Eisenhut |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174580948 PECOS PAC ID: 4284847021 Enrollment ID: I20160829000339 |
| Provider Name | Zachary D Liapis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154700359 PECOS PAC ID: 1052624459 Enrollment ID: I20180223001155 |
| Provider Name | Stephanie Anne Morrison |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568656478 PECOS PAC ID: 3971821067 Enrollment ID: I20180604002525 |
| Provider Name | Megan Wurm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720440498 PECOS PAC ID: 0143529008 Enrollment ID: I20190605001643 |
| Provider Name | Teresa Lynn Vanhoose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568012300 PECOS PAC ID: 7113359886 Enrollment ID: I20191118003006 |
| Provider Name | Ayana Ashay Kleckner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942822499 PECOS PAC ID: 0446675805 Enrollment ID: I20200731001364 |
| Provider Name | Kristina Kaye Helmick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538539515 PECOS PAC ID: 3476951989 Enrollment ID: I20211014001226 |
| Provider Name | Jessica C Emmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821758822 PECOS PAC ID: 1759773310 Enrollment ID: I20220112000849 |
| Provider Name | Lisa Peterson Salata |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710081096 PECOS PAC ID: 9032259270 Enrollment ID: I20230810001078 |
| Provider Name | Rebecca Sprauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922782077 PECOS PAC ID: 1456715192 Enrollment ID: I20230913001994 |
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