OrganizationActive
Providence Medical Group
NPI 1811304595 · Podiatrist · Moraine, OH
Providence Medical Group is a Podiatrist organization in Moraine, OH (NPI 1811304595).
Provider details
- NPI number
- 1811304595
- Entity type
- Organization
- Primary specialty
- PodiatristPodiatric Medicine & Surgery Service Providers
- Parent organization
- Providence Podiatry
- Organization subpart
- Yes
- Authorized official
- Susan Becker, Chief Operating Officer(937) 297-8999
- License
- 36.003657 (OH)
Specialties & taxonomies
Podiatric Medicine & Surgery Service Providers
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 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
2912 Springboro Rd
Suite 201
Moraine, OH 45439-1674
Phone: (937) 297-8999
Fax: (937) 297-4852
Street-level locationGet directions
Mailing address
2912 Springboro Rd
Moraine, OH 45439-1674
Registry dates
- Enumerated
- 2014-07-15
- Last updated
- 2014-10-28
Frequently asked questions
- What is Providence Medical Group's NPI number?
- Providence Medical Group's National Provider Identifier (NPI) is 1811304595, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Providence Medical Group?
- Providence Medical Group is classified in the NPPES registry as Podiatrist (Podiatric Medicine & Surgery Service Providers).
- Where is Providence Medical Group located?
- Providence Medical Group's practice location on file with NPPES is 2912 Springboro Rd, Moraine, OH 45439-1674.
- What is Providence Medical Group's phone number?
- The practice phone number listed in the NPPES registry for Providence Medical Group is (937) 297-8999.
- Who is the authorized official for Providence Medical Group?
- The authorized official listed on Providence Medical Group's NPPES record is Susan Becker, Chief Operating Officer. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Providence Medical Group's NPI active?
- Yes — Providence Medical Group's NPI (1811304595) is active in the NPPES registry as of the last update on 2014-10-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.