| Samaritan Family Care Inc | |
|
3170 Kettering Blvd Building B 3rd Floor Moraine OH 45439-1924 | |
| (937) 991-3188 | |
| (937) 223-9811 |
| Full Name | Samaritan Family Care Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 3170 Kettering Blvd, Moraine, Ohio |
| Authorized Official Name and Position | Darlene F Michel (SYSTEMS SUPPORT ANALYST) |
| Authorized Official Contact | 9374996758 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samaritan Family Care Inc 3170 Kettering Blvd Building B 3rd Floor Moraine OH 45439-1924 Ph: (937) 991-3188 | Samaritan Family Care Inc 3170 Kettering Blvd Building B 3rd Floor Moraine OH 45439-1924 Ph: (937) 991-3188 |
| NPI Number | 1659503886 |
|---|---|
| Provider Enumeration Date | 08/21/2009 |
| Last Update Date | 11/08/2024 |
| Medicare PECOS PAC ID | 5092608372 |
|---|---|
| Medicare Enrollment ID | O20040203000210 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659503886 | NPI | - | NPPES |
| 0081307 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Robert Morrison |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1114925682 PECOS PAC ID: 1254243249 Enrollment ID: I20040209000015 |
| Provider Name | Yoichi C Imamura |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679687479 PECOS PAC ID: 5496643868 Enrollment ID: I20040308000662 |
| Provider Name | Farzin Foruhari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942249594 PECOS PAC ID: 0941192512 Enrollment ID: I20040327000440 |
| Provider Name | Mohamud Si Mohamed |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700869377 PECOS PAC ID: 4981697935 Enrollment ID: I20040406000208 |
| Provider Name | Mark Eric Corcoran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740220854 PECOS PAC ID: 5597737403 Enrollment ID: I20040811000467 |
| Provider Name | Susan Meera Grandhi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073686838 PECOS PAC ID: 6800863747 Enrollment ID: I20040910001274 |
| Provider Name | Susan F Davis Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912992165 PECOS PAC ID: 9830152016 Enrollment ID: I20041109000304 |
| Provider Name | Angela Christine Long Prentice |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770523185 PECOS PAC ID: 9537101019 Enrollment ID: I20050525000194 |
| Provider Name | Christopher J Lauricella |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316942063 PECOS PAC ID: 1052356185 Enrollment ID: I20050620001140 |
| Provider Name | Genevieve Charlotte Bates |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710071287 PECOS PAC ID: 7214973080 Enrollment ID: I20050701000178 |
| Provider Name | Pamela J Acopine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932182961 PECOS PAC ID: 9739110800 Enrollment ID: I20050829000404 |
| Provider Name | Katrina K Paulding |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578510335 PECOS PAC ID: 7113944828 Enrollment ID: I20051101000185 |
| Provider Name | David A Mesker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093793762 PECOS PAC ID: 4789603051 Enrollment ID: I20051116000091 |
| Provider Name | Sukaina J Jaffer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568430031 PECOS PAC ID: 5991714404 Enrollment ID: I20060411000706 |
| Provider Name | Robert F Linn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225085210 PECOS PAC ID: 8123036951 Enrollment ID: I20060712000091 |
| Provider Name | Radhika R Akella |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619905601 PECOS PAC ID: 7618970880 Enrollment ID: I20060809000275 |
| Provider Name | Johan Worndle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295840833 PECOS PAC ID: 8729083696 Enrollment ID: I20060927000419 |
| Provider Name | Kombian Gbaruk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235171802 PECOS PAC ID: 3577569342 Enrollment ID: I20061018000584 |
| Provider Name | James Emiel Decaestecker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376533463 PECOS PAC ID: 1355348228 Enrollment ID: I20061107000367 |
| Provider Name | Elaine K Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285700757 PECOS PAC ID: 1355342809 Enrollment ID: I20070125000282 |
| Provider Name | Michele D Torres |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407877715 PECOS PAC ID: 4284739871 Enrollment ID: I20070410000173 |
| Provider Name | Rameswar Chaudhuri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104915602 PECOS PAC ID: 7618901950 Enrollment ID: I20070424000505 |
| Provider Name | Sunila Paul |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699826776 PECOS PAC ID: 2567554579 Enrollment ID: I20070822001073 |
| Provider Name | Vinh Truyen Quoc Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679693105 PECOS PAC ID: 3870689490 Enrollment ID: I20071012000274 |
| Provider Name | Ravindra Mullapudi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811943822 PECOS PAC ID: 3072600550 Enrollment ID: I20071031000031 |
| Provider Name | Chaitanya S Kadakia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932118726 PECOS PAC ID: 3870527781 Enrollment ID: I20080114000390 |
| Provider Name | Duane P Dickens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568401685 PECOS PAC ID: 4385723931 Enrollment ID: I20080507000343 |
| Provider Name | Tara Jolene Scheufler |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063566826 PECOS PAC ID: 7315954658 Enrollment ID: I20081230000438 |
| Provider Name | Helen Gwendolyn Gerhard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750547345 PECOS PAC ID: 7416010111 Enrollment ID: I20090107000026 |
| Provider Name | Kathryn A Streb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902077233 PECOS PAC ID: 0648334912 Enrollment ID: I20090131000004 |
| Provider Name | Kirshan Lal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316964398 PECOS PAC ID: 7315956323 Enrollment ID: I20090323000320 |
| Provider Name | Jeffrey G Poulos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871633776 PECOS PAC ID: 1153474663 Enrollment ID: I20090731000212 |
| Provider Name | Joseph P Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952516544 PECOS PAC ID: 3173677606 Enrollment ID: I20090819000199 |
| Provider Name | Robert Harrington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710941513 PECOS PAC ID: 3173663754 Enrollment ID: I20091211000230 |
| Provider Name | Michael W Barrow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700826005 PECOS PAC ID: 2163562067 Enrollment ID: I20091229000041 |
| Provider Name | Kimberly F Bethel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215982574 PECOS PAC ID: 7012058522 Enrollment ID: I20100106000370 |
| Provider Name | James D Aldstadt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245287911 PECOS PAC ID: 0648311696 Enrollment ID: I20100113000028 |
| Provider Name | H Todd Kepler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053368910 PECOS PAC ID: 1355483785 Enrollment ID: I20100125000086 |
| Provider Name | Salva Garcia Bernal Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346287091 PECOS PAC ID: 3870635980 Enrollment ID: I20100127000363 |
| Provider Name | Abdul Naser Butman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912953472 PECOS PAC ID: 9032251145 Enrollment ID: I20100127000387 |
| Provider Name | Ronald L Mcgilton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407896061 PECOS PAC ID: 1355483488 Enrollment ID: I20100127000514 |
| Provider Name | Annadorai Kalahasthy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023064433 PECOS PAC ID: 7810030731 Enrollment ID: I20100201000415 |
| Provider Name | Julie Larson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346296589 PECOS PAC ID: 3779626445 Enrollment ID: I20100203000217 |
| Provider Name | Jason Schatzel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427097922 PECOS PAC ID: 4082757729 Enrollment ID: I20100203000860 |
| Provider Name | Isaac Corney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710932900 PECOS PAC ID: 4587707120 Enrollment ID: I20100204000808 |
| Provider Name | Polina Sadikov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376590091 PECOS PAC ID: 6608919923 Enrollment ID: I20100208000626 |
| Provider Name | Walter A Reiling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467409706 PECOS PAC ID: 2466595780 Enrollment ID: I20100208000665 |
| Provider Name | Kathryn E Lorenz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770798340 PECOS PAC ID: 7214070564 Enrollment ID: I20100209000107 |
| Provider Name | Patricia A Grice |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891759668 PECOS PAC ID: 9032254339 Enrollment ID: I20100310000678 |
| Provider Name | Ramamohan Chunduri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598739963 PECOS PAC ID: 8820125420 Enrollment ID: I20100429000602 |
| Provider Name | Ruth Muriithi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124209580 PECOS PAC ID: 3274659735 Enrollment ID: I20100922000522 |
| Provider Name | Abdul-mannan M Masood |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033397617 PECOS PAC ID: 1254457716 Enrollment ID: I20100922000544 |
| Provider Name | Suzanne Bell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023214103 PECOS PAC ID: 3870619349 Enrollment ID: I20100922000576 |
| Provider Name | Jeffrey Studebaker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356427140 PECOS PAC ID: 6103942396 Enrollment ID: I20100929000001 |
| Provider Name | Miriam Emile |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831209923 PECOS PAC ID: 2668577453 Enrollment ID: I20101005000739 |
| Provider Name | Robert Bruce Elson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174825244 PECOS PAC ID: 9830373992 Enrollment ID: I20110414000079 |
| Provider Name | Asha Agarwal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407844939 PECOS PAC ID: 8426234949 Enrollment ID: I20110518000471 |
| Provider Name | Hemapriya Kumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750582318 PECOS PAC ID: 2163560798 Enrollment ID: I20110610000162 |
| Provider Name | Harmanpreet S Shinh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578729174 PECOS PAC ID: 6709054299 Enrollment ID: I20110728000377 |
| Provider Name | Sreevani Gollamudi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053572057 PECOS PAC ID: 1052508702 Enrollment ID: I20110902000298 |
| Provider Name | Sudhir Dhobale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124294988 PECOS PAC ID: 4183817695 Enrollment ID: I20111014000386 |
| Provider Name | Mohammed M Abdelaziz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831326701 PECOS PAC ID: 6406021849 Enrollment ID: I20111213000464 |
| Provider Name | Michael Boggs |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417956772 PECOS PAC ID: 7911931027 Enrollment ID: I20120215000404 |
| Provider Name | Carol L Bland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508975632 PECOS PAC ID: 9436310463 Enrollment ID: I20120418000229 |
| Provider Name | Jon B Silk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720277486 PECOS PAC ID: 3870758048 Enrollment ID: I20120713000382 |
| Provider Name | Yousif Sm Shareef |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922235811 PECOS PAC ID: 4789840547 Enrollment ID: I20120723000631 |
| Provider Name | Golibe A Nwafo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1588952907 PECOS PAC ID: 7214183409 Enrollment ID: I20120802000729 |
| Provider Name | Amith Parekh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750510715 PECOS PAC ID: 7113194531 Enrollment ID: I20120815000836 |
| Provider Name | Abidemi B Akande |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518281690 PECOS PAC ID: 7416106869 Enrollment ID: I20121001000045 |
| Provider Name | Susan Belle Malott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255594610 PECOS PAC ID: 4183774011 Enrollment ID: I20121120000557 |
| Provider Name | Amish A Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083938906 PECOS PAC ID: 3870748445 Enrollment ID: I20130305000364 |
| Provider Name | Jennifer K Hartsock-vandine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528386604 PECOS PAC ID: 7012152556 Enrollment ID: I20130403000551 |
| Provider Name | Milinda Nimmo Zabramba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821316787 PECOS PAC ID: 4688810278 Enrollment ID: I20130426000680 |
| Provider Name | Chelsea B Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316287600 PECOS PAC ID: 6608013651 Enrollment ID: I20130510000122 |
| Provider Name | Amie Ogunsakin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952533580 PECOS PAC ID: 2163661729 Enrollment ID: I20130612000400 |
| Provider Name | Alpa Kunal Desai |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1518281591 PECOS PAC ID: 0345489837 Enrollment ID: I20130612000741 |
| Provider Name | Andrew J Diller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376778654 PECOS PAC ID: 1355584400 Enrollment ID: I20130821000698 |
| Provider Name | Angelia M Mickle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790117141 PECOS PAC ID: 0840433058 Enrollment ID: I20130925000618 |
| Provider Name | Ali T Jaffery |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649489105 PECOS PAC ID: 4688809049 Enrollment ID: I20131021001510 |
| Provider Name | Spencer Dennis Wolf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700179744 PECOS PAC ID: 9234364290 Enrollment ID: I20131028001812 |
| Provider Name | Leo Lasala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831426618 PECOS PAC ID: 9335375591 Enrollment ID: I20131115001518 |
| Provider Name | Leelmohan Ravikumar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881903656 PECOS PAC ID: 4587890603 Enrollment ID: I20131120000981 |
| Provider Name | Estella Jo Wetzel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548698574 PECOS PAC ID: 3779714100 Enrollment ID: I20140327000560 |
| Provider Name | Seth Tyler Kettel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407149800 PECOS PAC ID: 0648408302 Enrollment ID: I20140401000504 |
| Provider Name | Amy M Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992949150 PECOS PAC ID: 2860629979 Enrollment ID: I20140626002344 |
| Provider Name | Kathy O Ferriell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710932868 PECOS PAC ID: 7618937384 Enrollment ID: I20150116001142 |
| Provider Name | Madhusudhan Tarigopula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235340621 PECOS PAC ID: 5890880371 Enrollment ID: I20150310001946 |
| Provider Name | Effiok S Ekpenyong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225392053 PECOS PAC ID: 4284695065 Enrollment ID: I20150406000347 |
| Provider Name | Kunal Desai |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1912189986 PECOS PAC ID: 5193859445 Enrollment ID: I20150421000795 |
| Provider Name | Gaurang P Mavani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306862909 PECOS PAC ID: 6901820554 Enrollment ID: I20150624003139 |
| Provider Name | Ashley N Hoskins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801266101 PECOS PAC ID: 7214237205 Enrollment ID: I20151123002908 |
| Provider Name | Ashleigh Stroble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568834901 PECOS PAC ID: 1355641705 Enrollment ID: I20151208000683 |
| Provider Name | Daniel C Opris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740547983 PECOS PAC ID: 4688819063 Enrollment ID: I20151209001357 |
| Provider Name | Clista A Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467811695 PECOS PAC ID: 3173820727 Enrollment ID: I20160324001283 |
| Provider Name | Kirti Sanders |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700227113 PECOS PAC ID: 4284957465 Enrollment ID: I20160728001209 |
| Provider Name | Paul Nangoh Elangwe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700225893 PECOS PAC ID: 1951696046 Enrollment ID: I20160829001877 |
| Provider Name | Muhanad Al-zubaidi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952627622 PECOS PAC ID: 1951543297 Enrollment ID: I20160922002477 |
| Provider Name | Brian Perkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679913594 PECOS PAC ID: 9436440120 Enrollment ID: I20160922002908 |
| Provider Name | Nuzhat Un Nisa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306036140 PECOS PAC ID: 1254456072 Enrollment ID: I20160923000752 |
| Provider Name | Heather N Branam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598212615 PECOS PAC ID: 2365730462 Enrollment ID: I20161005000739 |
| Provider Name | Nikhil Prasad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114364460 PECOS PAC ID: 8325336431 Enrollment ID: I20161005001281 |
| Provider Name | Charissa Lateesha Geyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699018630 PECOS PAC ID: 6800020850 Enrollment ID: I20161005002896 |
| Provider Name | Sari A Bright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033562582 PECOS PAC ID: 4486932605 Enrollment ID: I20161024000041 |
| Provider Name | Sonam Norbu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144674821 PECOS PAC ID: 8224316948 Enrollment ID: I20161101001604 |
| Provider Name | Meta Lisa Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750836565 PECOS PAC ID: 3971882119 Enrollment ID: I20161111000377 |
| Provider Name | Novera Inam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215975354 PECOS PAC ID: 1557431996 Enrollment ID: I20161116002786 |
| Provider Name | Desiree Nicole Vance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679022933 PECOS PAC ID: 5395024095 Enrollment ID: I20161121002410 |
| Provider Name | Lynn M Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194177477 PECOS PAC ID: 7911287297 Enrollment ID: I20161201002400 |
| Provider Name | Michael Hayden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740544501 PECOS PAC ID: 1254611981 Enrollment ID: I20161214002208 |
| Provider Name | Francis Chikadibia Nwanyanwu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871932970 PECOS PAC ID: 5991086258 Enrollment ID: I20161227001898 |
| Provider Name | Arthur Macneill Horton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225474331 PECOS PAC ID: 8426288192 Enrollment ID: I20170215001869 |
| Provider Name | Sarah J Neal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144770454 PECOS PAC ID: 3375820640 Enrollment ID: I20170516000634 |
| Provider Name | Amy Letts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124560016 PECOS PAC ID: 0446529515 Enrollment ID: I20170705001266 |
| Provider Name | Abayomi Ogunderu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346656741 PECOS PAC ID: 5991074080 Enrollment ID: I20170705002306 |
| Provider Name | William Casmir Dailey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962812974 PECOS PAC ID: 8325260474 Enrollment ID: I20170719002182 |
| Provider Name | Jessica Tipton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790208577 PECOS PAC ID: 8729350582 Enrollment ID: I20170815001260 |
| Provider Name | Paul Evens Gregoire Charles |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578974556 PECOS PAC ID: 3971814658 Enrollment ID: I20170815004393 |
| Provider Name | Darla Carol Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144748807 PECOS PAC ID: 4587938345 Enrollment ID: I20170919000462 |
| Provider Name | Huijie Zhang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710402433 PECOS PAC ID: 8820363203 Enrollment ID: I20171011001497 |
| Provider Name | Trisha M Strayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316214042 PECOS PAC ID: 8426328196 Enrollment ID: I20171025000821 |
| Provider Name | Mohammad M Losta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619394665 PECOS PAC ID: 2264658194 Enrollment ID: I20171102000533 |
| Provider Name | Leslee Mcelrath |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952747396 PECOS PAC ID: 5799913463 Enrollment ID: I20180321001428 |
| Provider Name | Afi Edi Agbo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912413162 PECOS PAC ID: 7618230392 Enrollment ID: I20180410002906 |
| Provider Name | Sara E Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316455934 PECOS PAC ID: 6507129202 Enrollment ID: I20180411000736 |
| Provider Name | Samantha Marie Loel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477045896 PECOS PAC ID: 9931458908 Enrollment ID: I20180823003521 |
| Provider Name | Jacqueline R Isaacs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316252349 PECOS PAC ID: 7113279993 Enrollment ID: I20181004003072 |
| Provider Name | Shannon Shea Stireman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730663238 PECOS PAC ID: 2062757974 Enrollment ID: I20181221000687 |
| Provider Name | Elizabeth R Swartzwelder-cozad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306223060 PECOS PAC ID: 5496069346 Enrollment ID: I20190116000478 |
| Provider Name | Joseph Dean Hester |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477661478 PECOS PAC ID: 6800950031 Enrollment ID: I20190312001492 |
| Provider Name | Rebecca A Boatman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508326042 PECOS PAC ID: 6608117122 Enrollment ID: I20190410002534 |
| Provider Name | Brenda Lee Chewning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528613254 PECOS PAC ID: 9133457088 Enrollment ID: I20190829004366 |
| Provider Name | Hamid Bashir |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1225257694 PECOS PAC ID: 6507911559 Enrollment ID: I20200224002631 |
| Provider Name | Kevin Carl Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023658218 PECOS PAC ID: 8628406196 Enrollment ID: I20200316001344 |
| Provider Name | Jessica Lynn Denlinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710527601 PECOS PAC ID: 5890116891 Enrollment ID: I20200529001373 |
| Provider Name | Lindsey N Draper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861028169 PECOS PAC ID: 0345662359 Enrollment ID: I20200622000399 |
| Provider Name | Jeffrey James Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487112413 PECOS PAC ID: 9931528577 Enrollment ID: I20200930002292 |
| Provider Name | Alyson A Malarkey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588051130 PECOS PAC ID: 0446548044 Enrollment ID: I20201005002038 |
| Provider Name | Gerald Ferg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932610334 PECOS PAC ID: 7113347501 Enrollment ID: I20201023002887 |
| Provider Name | Tiffany M Koors |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225630833 PECOS PAC ID: 3971910001 Enrollment ID: I20210413002399 |
| Provider Name | Alicia N Walls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558960674 PECOS PAC ID: 7810306016 Enrollment ID: I20210428002895 |
| Provider Name | Brittany An Voland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417621897 PECOS PAC ID: 4082010772 Enrollment ID: I20210903001118 |
| Provider Name | Christopher Jacob Pope |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093200263 PECOS PAC ID: 1254738685 Enrollment ID: I20210927003007 |
| Provider Name | Kayla Marie Bostwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992466221 PECOS PAC ID: 0345633178 Enrollment ID: I20220131001294 |
| Provider Name | Brittany Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558028456 PECOS PAC ID: 3476946062 Enrollment ID: I20220202003013 |
| Provider Name | Breanne Marie Mauk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588300339 PECOS PAC ID: 7315325636 Enrollment ID: I20220527000847 |
| Provider Name | Yi-wen Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417306366 PECOS PAC ID: 1557654324 Enrollment ID: I20220719000398 |
| Provider Name | Erica Lillyan Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265191456 PECOS PAC ID: 2567859465 Enrollment ID: I20220815000520 |
| Provider Name | Miguel Angel Paulet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548903834 PECOS PAC ID: 8921481243 Enrollment ID: I20220819001218 |
| Provider Name | Nita Sharon Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427511153 PECOS PAC ID: 1850767856 Enrollment ID: I20221017001193 |
| Provider Name | Dena Rae Kirklin-thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326774167 PECOS PAC ID: 4486024932 Enrollment ID: I20221228001512 |
| Provider Name | Molly Arianne Rossi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013606284 PECOS PAC ID: 8224495015 Enrollment ID: I20230609001787 |
| Provider Name | Zukhra Kuchiyeva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558088559 PECOS PAC ID: 2668832619 Enrollment ID: I20230721001886 |
| Provider Name | Bethany Suzanne Purtell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447036082 PECOS PAC ID: 0446607790 Enrollment ID: I20231108003508 |
| Provider Name | Joshua David Wheeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497534622 PECOS PAC ID: 4082061783 Enrollment ID: I20231116001706 |
| Provider Name | Delani Loralye Deckard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871350520 PECOS PAC ID: 6103265061 Enrollment ID: I20240411004634 |
Pyramid Healthcare, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3055 Kettering Blvd Ste 101, Moraine, OH 45439 Phone: 234-430-1078 | |
South Community Primary Care Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3095 Kettering Blvd, Moraine, OH 45439 Phone: 937-531-1974 Fax: 937-534-1579 | |
Harmonycares Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3033 Kettering Blvd, Ste. 100, Moraine, OH 45439 Phone: 937-293-2133 Fax: 937-293-2161 | |
Ecg Scanning & Medical Services, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3055 Kettering Blvd Ste 219-a, Moraine, OH 45439 Phone: 800-346-5837 Fax: 937-395-4415 | |
Mvhe Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3170 Kettering Blvd, Building B 3rd Floor, Moraine, OH 45439 Phone: 937-991-3188 Fax: 937-223-9811 | |
Family Practice Associates Of Dayton Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5350 Lamme Rd, Moraine, OH 45439 Phone: 937-451-3123 Fax: 937-350-6477 |