ALLIANCE PHYSICIAN INC (NPI# 1255613659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255613659 |
| Entity Type | Organization |
| Organization Name | ALLIANCE PHYSICIAN INC |
| Other Organization Name | KETTERING ACUTE CARE SURGERY |
| Practice Address |
3535 Southern Blvd Suite A Kettering OH 45429-1221 |
| Mailing Address |
2110 Leiter Rd Miamisburg OH 45342-3660 |
| Practice Telephone | 9373956010 |
| Practice Fax Number | 9373958162 |
| Mailing Telephone | 9373844838 |
| Mailing Fax Number | 9373844845 |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2011-09-13 |
| Authorized Official Name | DANIEL D HAIBACH (DIRECTOR BUSINESS DEVELOPMENT) |
| Authorized Official Telephone | 9375583222 |
| Is Organization Subpart | Y |
| Parent Organization Name | ALLIANCE PHYSICIAN INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2712872 | 05 |
| Other Name | Type Code |
|---|---|
| Kettering Acute Care Surgery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821160243 | Alliance Physician Inc | Family Medicine | 4403 Far Hills Ave, Kettering, OH 45429-2405 | 2006-11-14 |
| 1891077194 | Alliance Physician Inc | Neurological Surgery | 3533 Southern Blvd, Suite 5350, Kettering, OH 45429-1263 | 2011-09-13 |
| 1285916585 | Alliance Physician Inc | Psychiatry & Neurology | 3533 Southern Blvd, Suite 5200, Kettering, OH 45429-1275 | 2011-09-13 |
| 1598047813 | Alliance Physician Inc | Orthopaedic Surgery | 2350 Miami Valley Dr, Suite 320, Centerville, OH 45459-4000 | 2011-09-13 |
| 1275815672 | Alliance Physician Inc | Internal Medicine | 3737 Southern Blvd, Suite 3200, Kettering, OH 45429-1286 | 2011-09-13 |
| 1710269113 | Alliance Physician Inc | Obstetrics & Gynecology | 3737 Southern Blvd, Suite 3100, Kettering, OH 45429-1286 | 2011-09-13 |
| 1669754065 | Alliance Physician Inc | Physician Assistant | 405 W Grand Ave, Or Dept, Dayton, OH 45405-4720 | 2011-09-13 |
| 1104108406 | Alliance Physician Inc | Surgery | 1 Elizabeth Pl, Suite 10a-1, Dayton, OH 45417-3445 | 2011-09-13 |
| 1629350020 | Alliance Physician Inc | Surgery | 3737 Southern Blvd, Suite 2000a, Kettering, OH 45429-1262 | 2011-09-13 |
| 1679855985 | Alliance Physician Inc | Urology | 7756 Washington Village Dr, Suite 135, Centerville, OH 45459-3953 | 2011-09-13 |
| Street Address |
3535 SOUTHERN BLVD SUITE A |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-1221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134124183 | David M Brouhard | Anesthesiology | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2005-06-16 |
| 1245846757 | Rachel Henderson | Pharmacist | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-09-21 |
| 1235745043 | Nipa Mukesh Patel | Pharmacist | 3535 Southern Blvd, Kettering, OH 45429-1298 | 2020-09-17 |
| 1104437425 | Stephanie Elizabeth Nicholls | Hospitalist | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-08-11 |
| 1346865144 | Anesthesia Pearls, LLC | Nurse Anesthetist, Certified Registered | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-06-08 |
| 1568087351 | Pearl Lee | Nurse Anesthetist, Certified Registered | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-06-08 |
| 1922631761 | Michael Patrick Lorey | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-02-20 |
| 1801446315 | Madison A Tate | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-09-17 |
| 1962058966 | Joshua Caleb Courlas | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-08-15 |
| 1134775273 | Jason Raymond Leigh | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-08-14 |
| Find all providers in the same location | ||||
| 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 | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003178427 | Andrew Loudon | Surgery | 395 W 12th Ave Ste 634, Columbus, OH 43210 | 2012-06-12 |
| 1306070867 | Robert Edward Falcone | Surgery | 150 E Lafayette St, Columbus, OH 43215-2948 | 2009-05-12 |
| 1720277494 | Amy Marie Jarvis | Surgery | 1 Akron General Ave Ste 359, Akron, OH 44307-2432 | 2007-10-18 |
| 1407811862 | William F Fallon | Surgery | 550 E Market St, Suite 103, Akron, OH 44304-1613 | 2006-04-19 |
| 1114586641 | Katharine Tavani | Surgery | 1 Perkins Sq, Akron, OH 44308-1063 | 2019-06-09 |
| 1902294556 | Victor Dizon, D.o., Facos, Inc | Surgery | 793 W State St, Columbus, OH 43222-1551 | 2015-01-06 |
| 1972865350 | Kevin Vincent Schrand | Surgery | 234 Goodman St, Cincinnati, OH 45219-2364 | 2012-06-12 |
| 1174803282 | Esther Tseng | Surgery | 2500 Metrohealth Dr, Cleveland, OH 44109-1900 | 2011-08-19 |
| 1619137601 | Urmil B Pandya | Surgery | 111 S Grant Ave, Trauma Services, Columbus, OH 43215-4701 | 2008-06-12 |
| 1649469495 | Shrawan Gaitonde | Surgery | 234 Goodman St., Cincinnati, OH 45219 | 2007-10-17 |
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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.