KEVIN G MALLOY MD, LLC (NPI# 1003869199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003869199 |
| Entity Type | Organization |
| Organization Name | KEVIN G MALLOY MD, LLC |
| Practice Address |
5250 Far Hills Ave Ste 250 Kettering OH 45429-2353 |
| Practice Telephone | 9374356500 |
| Practice Fax Number | 9374356514 |
| Mailing Telephone | 9374356500 |
| Mailing Fax Number | 9374356514 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | KEVIN G MALLOY (OWNER) |
| Authorized Official Telephone | 9374356500 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
5250 FAR HILLS AVE STE 250 |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-2353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134337934 | Donna Lynn Weeber | Specialist/Technologist | 5250 Far Hills Ave, Ste 220, Kettering, OH 45429-2382 | 2007-05-18 |
| 1578605440 | Stephen A Weeber Dpm | Podiatrist | 5250 Far Hills Ave, Ste 220, Kettering, OH 45429-2353 | 2007-02-13 |
| 1750339685 | Raymond G. Russell | Internal Medicine | 5250 Far Hills Ave, Suite 150, Kettering, OH 45429 | 2006-05-04 |
| 1861450363 | Premier Integrated Medical Assoc Ltd | Pediatrics | 5250 Far Hills Ave, Kettering, OH 45429-2382 | 2006-05-03 |
| 1255397956 | George Gateley Burton | Internal Medicine | 5250 Far Hills Ave, Suite #150, Kettering, OH 45429 | 2006-04-22 |
| 1366407355 | Rita Winton Heritage | Pediatrics | 5250 Far Hills Ave, Kettering, OH 45429-2382 | 2006-04-20 |
| 1427047570 | Robert A Cain | Internal Medicine | 5250 Far Hills Ave, Suite 210, Kettering, OH 45429-2382 | 2005-10-20 |
| 1467444307 | Stephen Adams Weeber | Podiatrist | 5250 Far Hills Ave, Ste 220, Kettering, OH 45429-2382 | 2005-08-17 |
| 1992706816 | Nancy Wenchin Liu | Internal Medicine | 5250 Far Hills Ave, Suite 250, Kettering, OH 45429-2382 | 2005-08-02 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821361510 | William A Erwin | Family Medicine | 4717 Elzo Ln, Kettering, OH 45440-2026 | 2012-02-12 |
| 1376764944 | Letitia Canice Thompson-hargrave | Family Medicine | 513 E Stroop Rd, Kettering, OH 45429-3224 | 2007-05-01 |
| 1023102084 | Christian E. Koch | Family Medicine | 3080 Ackerman Blvd Ste 110, Kettering, OH 45429-3559 | 2006-10-03 |
| 1437256187 | Joseph Gregory Dudash | Family Medicine | 500 Lincoln Park Blvd Ste 220, Kettering, OH 45429-6404 | 2006-09-17 |
| 1134131519 | Carol Gaut Ryan | Family Medicine | 1360 E Stroop Rd, Kettering, OH 45429-4926 | 2006-08-13 |
| 1922051994 | Mvhe Inc | Family Medicine | 1525 E Stroop Rd, Suite 200, Kettering, OH 45429-5065 | 2006-05-18 |
| 1932163409 | James A. Derksen | Family Medicine | 1900 Composite Drive, Kettering, OH 45420-1475 | 2006-04-13 |
| 1366429342 | Carillon Family Practice Ltd | Family Medicine | 2501 S Dixie Dr, Kettering, OH 45409-1523 | 2005-12-29 |
| 1053307447 | Bradford J Murphy | Family Medicine | 3716 Wilmington Pike, Kettering, OH 45429-4845 | 2005-09-21 |
| 1184624413 | Arvin K Nanda | Family Medicine | 4441 Far Hills Ave, Kettering, OH 45429 | 2005-07-28 |
| Find all providers in KETTERING | ||||
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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.