KETTERING UROLOGY INSTITUTE INC (NPI# 1992956296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992956296 |
| Entity Type | Organization |
| Organization Name | KETTERING UROLOGY INSTITUTE INC |
| Practice Address |
3533 Southern Blvd Ste 5800 Kettering OH 45429-1264 |
| Mailing Address |
114 S Broadway St Greenville OH 45331-1902 |
| Practice Telephone | 9374387682 |
| Practice Fax Number | 9375472575 |
| Mailing Telephone | 9375470330 |
| Mailing Fax Number | 9375472575 |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2008-10-06 |
| Authorized Official Name | DR. EDWARD C JACOBS (PRESIDENT) |
| Authorized Official Telephone | 9375470330 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 35-07-3367 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | LICENSE | 35-07-3367 | 01 |
| Street Address |
3533 SOUTHERN BLVD STE 5800 |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-1264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285630137 | V. Joseph Karnitis | Obstetrics & Gynecology | 3533 Southern Blvd, Suite 4100, Kettering, OH 45429-1264 | 2005-06-24 |
| 1881208346 | Alexander John Armstrong | Physician Assistant | 3533 Southern Blvd, Kettering, OH 45429-1264 | 2020-09-02 |
| 1740739051 | Angela Yost | Nurse Practitioner | 3533 Southern Blvd, Suite 5350, Kettering, OH 45429-1264 | 2016-09-27 |
| 1215385968 | Angela Ponder | Dietitian, Registered | 3533 Southern Blvd, Suite 3750, Kettering, OH 45429-1264 | 2016-06-02 |
| 1992175798 | Megan Haas | Physician Assistant | 3533 Southern Blvd, Suite 5650, Kettering, OH 45429-1264 | 2015-10-06 |
| 1578931564 | Brian Wesche | Nurse Anesthetist, Certified Registered | 3533 Southern Blvd, Suite 3400, Kettering, OH 45429-1264 | 2015-09-08 |
| 1932577012 | Brooke Marie Obrien | Nurse Anesthetist, Certified Registered | 3533 Southern Blvd, Suite 3400, Kettering, OH 45429-1264 | 2015-09-08 |
| 1841682499 | Keith A Rooker | Nurse Anesthetist, Certified Registered | 3533 Southern Blvd, Ste 400, Kettering, OH 45429-1264 | 2015-02-19 |
| 1770972804 | Kristen Roth | Nurse Anesthetist, Certified Registered | 3533 Southern Blvd, Suite 3400, Kettering, OH 45429-1264 | 2015-01-13 |
| 1841600574 | Riyad J Tayim | Surgery | 3533 Southern Blvd, Ste 2250, Kettering, OH 45429-1270 | 2014-05-02 |
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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 |
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| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023597143 | Rajiva Ranjan Singh | Urology | 3737 Southern Blvd., Suite 4200, Kettering, OH 45429-1262 | 2018-08-09 |
| 1225223043 | David A Hadley | Urology | 3737 Southern Blvd Ste 4200, Kettering, OH 45429-0135 | 2007-09-14 |
| 1215298104 | Daniel Thomas Pucheril | Urology | 3737 Southern Blvd Ste 4200, Kettering, OH 45429-0135 | 2012-06-06 |
| 1306128608 | Alliance Physicians Inc | Urology | 10 Southmoor Cir Nw, Kettering, OH 45429-2486 | 2011-09-13 |
| 1811022619 | South Dayton Urological Associates | Urology | 10 Southmoor Cir Nw, Kettering, OH 45429-2444 | 2007-02-22 |
| 1891876470 | Safwat K. Zaki | Urology | 10 Southmoor Cir Nw, Kettering, OH 45429-2444 | 2006-10-18 |
| 1346321965 | Sammy A. Hamway | Urology | 10 Southmoor Cir Nw, Kettering, OH 45429-2444 | 2006-10-18 |
| 1275639908 | Male Reproductive Medicine of Southwest Ohio | Urology | 5692 Far Hills Ave, Kettering, OH 45429-2239 | 2006-09-16 |
| 1376508465 | Rafael Cruz | Urology | 3533 Southern Blvd, Kettering, OH 45429-1264 | 2006-04-20 |
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|---|---|---|---|---|
| 1699237909 | Tri State Urologic Services Psc Inc | Urology | 2123 Auburn Ave Ste 434, Cincinnati, OH 45219-2906 | 2019-04-04 |
| 1073075578 | Tri State Urologic Services Psc Inc | Urology | 7529 State Rd Ste B, Cincinnati, OH 45255-6410 | 2019-04-03 |
| 1194232876 | Nathan Ying-ho Hoy | Urology | 9500 Euclid Ave, Q10, Cleveland, OH 44195 | 2018-01-04 |
| 1982113197 | Alliance and Salem Urology LLC | Urology | 885 S Sawburg Ave Ste 105, Alliance, OH 44601-5905 | 2017-09-20 |
| 1447788468 | Robin Ann Houk | Urology | 95 Arch St Ste 165, Akron, OH 44304-1488 | 2017-06-03 |
| 1598216152 | Kings Daughters Medical Specialties Inc. | Urology | 1729 Kinneys Ln Ste 103, Portsmouth, OH 45662-3166 | 2016-10-19 |
| 1093162463 | Wmc Physician Practices LLC | Urology | 4100 Johnson Rd Ste 200, Steubenville, OH 43952-2372 | 2016-05-16 |
| 1154783223 | Wmc Physician Practices LLC | Urology | 251 E Market Street, Cadiz, OH 43907 | 2016-03-28 |
| 1144607508 | Johnathan Doolittle | Urology | 2050 E 96th St Q Building, Cleveland, OH 44195-3548 | 2015-05-05 |
| 1073932091 | Eric Jacob Fichtenbaum | Urology | 500 E Main St Ste 220, Columbus, OH 43215-5369 | 2014-04-08 |
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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.