Kettering Independent Medical Group Inc
NPI 1629387865 · Orthopaedic Surgery Physician · Miamisburg, OH
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kettering Independent Medical Group Inc is a Orthopaedic Surgery Physician organization in Miamisburg, OH (NPI 1629387865).
Provider details
- NPI number
- 1629387865
- Entity type
- Organization
- Primary specialty
- Orthopaedic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Timothy Ko, Chief Financial Officer(937) 395-8522
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
- Cardiovascular Disease Physician207RC0000X
Allopathic & Osteopathic Physicians
- Obstetrics & Gynecology Physician207V00000X
Allopathic & Osteopathic Physicians
- Surgery Physician208600000X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Former legal business name
- Kettering Specialty Care, Inc.
- Former legal business name
- Kettering Specialty Care, Inc.
Registry dates
- Enumerated
- 2010-10-06
- Last updated
- 2023-03-27
- Certified
- 2023-03-27
Frequently asked questions
- What is Kettering Independent Medical Group Inc's NPI number?
- Kettering Independent Medical Group Inc's National Provider Identifier (NPI) is 1629387865, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kettering Independent Medical Group Inc?
- Kettering Independent Medical Group Inc is classified in the NPPES registry as Orthopaedic Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Kettering Independent Medical Group Inc located?
- Kettering Independent Medical Group Inc's practice location on file with NPPES is 1 Prestige Pl, Miamisburg, OH 45342-3794.
- What is Kettering Independent Medical Group Inc's phone number?
- The practice phone number listed in the NPPES registry for Kettering Independent Medical Group Inc is (937) 762-1629.
- Does Kettering Independent Medical Group Inc accept Medicare?
- Kettering Independent Medical Group Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Kettering Independent Medical Group Inc?
- The authorized official listed on Kettering Independent Medical Group Inc's NPPES record is Timothy Ko, Chief Financial Officer. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kettering Independent Medical Group Inc's NPI active?
- Yes — Kettering Independent Medical Group Inc's NPI (1629387865) is active in the NPPES registry as of the last update on 2023-03-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.