MARK W MORONELL (NPI# 1306864608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306864608 |
| Entity Type | Individual |
| Full Name | MARK W MORONELL |
| Credential | M.D. |
| Practice Address |
1380 E Stroop Rd Kettering OH 45429 |
| Mailing Address |
1380 E Stroop Rd Kettering OH 45429-4926 |
| Practice Telephone | 9372933486 |
| Practice Fax Number | 9372933605 |
| Mailing Telephone | 9372933486 |
| Mailing Fax Number | 9372933605 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2018-07-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
35.122658 | OH | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
4457 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0097860 | 05 | |
| AK | MD1321 | 05 | |
| AK | RAILROAD MEDICARE | 060058886 | 01 |
| Street Address |
1380 E STROOP RD |
| City | KETTERING |
| State | OH |
| Zip Code | 45429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063494086 | Ajay Reddivari | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2005-11-16 |
| 1902208309 | Jacob D Sillaman | Physician Assistant | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2014-09-17 |
| 1821342320 | Sarah Christine Gibble | Physician Assistant | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2012-11-05 |
| 1013288166 | Amanda Yun Anania | Physician Assistant | 1380 E Stroop Rd, Kettering, OH 45429 | 2012-01-21 |
| 1396049011 | Ryan Stewart Clark | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2011-01-10 |
| 1144532409 | Mohammed O Ali | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2010-07-02 |
| 1720106685 | Nathaniel Joseph Dittoe | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2007-03-27 |
| 1750432811 | Cardiology South | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2007-01-16 |
| 1669456943 | Robert Woodrow Kiefaber | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2005-12-01 |
| 1023091501 | Calvert Raymond Busch | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2005-11-29 |
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| 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 | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063494086 | Ajay Reddivari | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2005-11-16 |
| 1215933387 | Reginald Sequeira | Internal Medicine | 540 Lincoln Park Blvd, Suite 200, Kettering, OH 45429-6401 | 2005-06-23 |
| 1720106685 | Nathaniel Joseph Dittoe | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2007-03-27 |
| 1720111487 | Schuster Cardiology Associates, Inc. | Internal Medicine | 3533 Southern Blvd, Suite 3550, Kettering, OH 45429-1264 | 2007-03-13 |
| 1750432811 | Cardiology South | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2007-01-16 |
| 1356364145 | John Lynch IIi | Internal Medicine | 540 Lincoln Park Blvd, Suite 200, Kettering, OH 45429-6401 | 2006-07-25 |
| 1164452645 | Southwest Cardiology Inc | Internal Medicine | 3533 Southern Blvd, Suite 2100, Kettering, OH 45429-1267 | 2006-07-03 |
| 1043277437 | Premier Integrated Medical Associates, Ltd | Internal Medicine | 540 Lincoln Park Blvd, Suite 200, Kettering, OH 45429-6401 | 2006-04-28 |
| 1669456943 | Robert Woodrow Kiefaber | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2005-12-01 |
| 1811971039 | Harvey Sungha Hahn | Internal Medicine | 3533 Southern Blvd, Suite 2100, Kettering, OH 45429-1264 | 2005-12-01 |
| 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.