ALLIANCE PHYSICIAN INC (NPI# 1821160243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1821160243 |
Entity Type | Organization |
Organization Name | ALLIANCE PHYSICIAN INC |
Other Organization Name | KETTERING SPORTS MEDICINE |
Practice Address |
4403 Far Hills Ave Kettering OH 45429-2405 |
Mailing Address |
1 Prestige Pl Suite 550 Miamisburg OH 45342-3794 |
Practice Telephone | 9373953920 |
Practice Fax Number | 9373953940 |
Mailing Telephone | 9377621305 |
Mailing Fax Number | 9375227513 |
Enumeration Date | 2006-11-14 |
Last Update Date | 2019-10-04 |
Authorized Official Name | TIMOTHY Y KO (CFO) |
Authorized Official Telephone | 9375583223 |
Is Organization Subpart | Y |
Parent Organization Name | ALLIANCE PHYSICIANS, INC |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OH | 2864833 | 05 |
Other Name | Type Code |
---|---|
Kettering Sports Medicine | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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 |
1568744969 | Alliance Physician Inc | Family Medicine | 38 Southmoor Cir Ne, Suite B, Kettering, OH 45429-2443 | 2011-09-13 |
Street Address |
4403 FAR HILLS AVE |
City | KETTERING |
State | OH |
Zip Code | 45429-2405 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649871245 | Janae Wicker | Specialist/Technologist | 4403 Far Hills Ave, Kettering, OH 45429-2405 | 2020-11-02 |
1922655174 | Tyler Anthony Bader | Physical Medicine & Rehabilitation | 4403 Far Hills Ave, Kettering, OH 45429-2405 | 2019-08-22 |
1538715032 | Hannah Haeseker | Specialist/Technologist | 4403 Far Hills Ave, Kettering, OH 45429-2405 | 2019-08-12 |
1932612850 | Michelle Heckman | Specialist/Technologist | 4403 Far Hills Ave, Kettering, OH 45429-2405 | 2017-11-14 |
1396256269 | Emery P Cowart | Specialist/Technologist | 4403 Far Hills Ave, Kettering, OH 45429-2405 | 2017-10-19 |
1134572332 | Heather Herbst | Specialist/Technologist | 4403 Far Hills Ave, Kettering, OH 45429-2405 | 2016-07-22 |
1497113773 | Sarah Neuss | Specialist/Technologist | 4403 Far Hills Ave, Kettering, OH 45429-2405 | 2016-02-02 |
1174989974 | Nathan Mcfadden I | Rehabilitation Hospital | 4403 Far Hills Ave, Kettering, OH 45429-2405 | 2016-01-08 |
1639568819 | Megan Davidson | Specialist/Technologist | 4403 Far Hills Ave, Kettering, OH 45429-2405 | 2015-01-12 |
1730515461 | Jonathan Robert Burtoft | Specialist/Technologist | 4403 Far Hills Ave, Kettering, OH 45429-2405 | 2013-09-26 |
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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 | 207QS0010X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Sports Medicine |
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
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1134547615 | Ryan E Hunt | Family Medicine | 140 Coleman's Crossing Blvd, Suite 110, Marysville, OH 43040 | 2014-04-02 |
1295152296 | Benjamin Ross Ahrens | Family Medicine | 4343 All Seasons Dr Ste 100, Hilliard, OH 43026-1961 | 2014-03-27 |
1083039309 | Jamie Delvecchio | Family Medicine | 150 7th Ave Ste 200, Chardon, OH 44024 | 2014-02-24 |
1669815445 | Anthony Peter Mckeen | Family Medicine | 1900 S Union Ave Ste 100, Alliance, OH 44601-4355 | 2013-04-11 |
1053661322 | Greene Memorial Hospital Services, Inc. | Family Medicine | 6645 Morris Rd, Hamilton, OH 45011-5417 | 2012-09-14 |
1700142734 | Jeffrey Aaron James | Family Medicine | 2350 Miami Valley Dr Ste 320a, Dayton, OH 45459-4778 | 2012-04-04 |
1568751790 | Raul A Raudales Jr. | Family Medicine | State Rte 159, Ste G15, Chillicothe, OH 45601 | 2011-03-28 |
1255639381 | Ohiohealth Corporation | Family Medicine | 1797 Hill Rd N Ste 100, Pickerington, OH 43147-7998 | 2011-03-15 |
1811295900 | Ohiohealth Corporation | Family Medicine | 94 N High St Ste 200, Dublin, OH 43017-1194 | 2011-03-14 |
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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.