KETTERING HEALTH PRIMARY CARE, A SERVICE OF KETTERING HEALTH GREENE ME
NPI 1073948774
Clinic/Center - Rural Health in Cedarville, OH

NPI Status: Active since September 12, 2013

Contact Information

29 KYLE DR
CEDARVILLE, OH
ZIP 45314
Phone: (937) 766-2611
Fax: (937) 766-5558

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  • Organization
  • Clinic/Center
  • Rural Health
  • Accepts Insurance
  • CLIA Number: 36D0897262
  • CLIA Cert. Type: Rural Health Clinic
  • CLIA Exp. Date: 07-11-2027

About KETTERING HEALTH PRIMARY CARE, A SERVICE OF KETTERING HEALTH GREENE ME

This page provides the complete NPI Profile along with additional information for Kettering Health Primary Care, A Service Of Kettering Health Greene Me, a primary care provider established in Cedarville, Ohio operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1073948774 assigned on September 2013. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Kettering Health Primary Care, A Service Of Kettering Health Greene Me. The authorized official of this NPI record is Timothy Ko (Network Cfo)

NPI
1073948774
Provider Legal Name
GREENE MEMORIAL HOSPITAL INC
Other Organization Name
KETTERING HEALTH PRIMARY CARE, A SERVICE OF KETTERING HEALTH GREENE ME
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
29 KYLE DR CEDARVILLE, OH 45314
Location Phone
(937) 766-2611
Location Fax
(937) 766-5558
Mailing Address
2110 LEITER RD MIAMISBURG, OH 45342
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
09-12-2013
Last Update Date
11-25-2024
Code Navigator

A primary care provider (PCP) like Kettering Health Primary Care, A Service Of Kettering Health Greene Me sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Rural Health

Taxonomy Code
261QR1300X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 10600 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 8500 for HSA - HMO
  • Anthem Gold Pathway 2000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Bronze Pathway 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Silver Pathway 5000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway 4000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway 5500 for HSA - HMO
  • Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Silver 6200 $3 Generic Drugs - HMO
  • Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Silver 6000 $20 Generic Drugs - HMO
  • Bronze $8,300 w/ Adult Dental ON-EX - HMO
  • Bronze $8,300 w/ Virtual & Wellness ON-EX - HMO
  • Bronze HSA $7,300 ON-EX - HMO
  • Bronze Standard w/ Virtual & Wellness - HMO
  • Gold $1,000 w/ Adult Dental ON-EX - HMO
  • Gold $1,000 w/ Virtual & Wellness ON-EX - HMO
  • Gold $500 w/ Virtual & Wellness ON-EX - HMO
  • Gold Standard w/ Virtual & Wellness - HMO
  • Silver $5,000 w/ Adult Dental ON-EX - HMO
  • Silver $5,000 w/ Virtual & Wellness ON-EX - HMO
  • Silver $5,800 w/ Virtual & Wellness ON-EX - HMO
  • Silver Standard w/ Virtual & Wellness - HMO
  • Molina Bronze Enhanced 3500 - HMO
  • Molina Bronze Enhanced 3500 Plus with Adult Dental and Vision - HMO
  • Molina Bronze Enhanced 3500 Plus with Adult Vision - HMO
  • Molina Bronze Saver 7000 - HMO
  • Molina Bronze Saver 7000 Plus with Adult Dental and Vision - HMO
  • Molina Bronze Saver 7000 Plus with Adult Vision - HMO
  • Molina Bronze Smart Heart Health - HMO
  • Molina Bronze Standard - HMO
  • Molina Gold Core 1640 - HMO
  • Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
  • Molina Gold Core 1640 Plus with Adult Vision - HMO
  • Molina Gold Enhanced 895 - HMO
  • Molina Gold Enhanced 895 Plus with Adult Dental and Vision - HMO
  • Molina Gold Enhanced 895 Plus with Adult Vision - HMO
  • Molina Gold Smart Heart Health - HMO
  • Molina Gold Standard - HMO
  • Molina Silver Core - HMO
  • Molina Silver Core Plus with Adult Dental and Vision - HMO
  • Molina Silver Core Plus with Adult Vision - HMO
  • Molina Silver Saver with Four Free PCP Visits - HMO
  • Bronze Classic 4700 - HMO
  • Bronze Classic Standard - HMO
  • Bronze Elite + PCP Saver Plus - HMO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
  • Bronze Simple Chronic Care CKM - HMO
  • Bronze Simple Diabetes - HMO
  • Gold Classic - HMO
  • Gold Classic Standard - HMO
  • Gold Elite Saver Plus - HMO
  • Silver Classic Standard - HMO
  • Silver Elite Saver Plus - HMO
  • Silver Simple Breathe Easy with Enhanced COPD Benefits - HMO
  • Silver Simple Chronic Care CKM - HMO
  • Silver Simple Diabetes - HMO
  • Silver Simple PCP Saver - HMO
  • Silver Simple Women's Health with Menopause Benefits - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Bronze Standard+ (Dental + Vision, No Referrals) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Gold Standard+ (Dental + Vision, No Referrals) - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Silver Standard (No Referrals) - HMO
  • UHC Silver Standard+ (Dental + Vision, No Referrals) - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

TIMOTHY KO

Authorized Official Title
NETWORK CFO
Authorized Official Phone
(937) 395-8522

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
0146442MEDICAID (05)OH 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
36D0897262
Facility Type
Rural Health Clinic
Certificate Effective Date
July 12, 2025
Certificate Expiration Date
July 11, 2027
Laboratory Director
DR. DENISE KENNEDY
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Kettering Health Primary Care, A Service Of Kettering Health Greene Me to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for KETTERING HEALTH PRIMARY CARE, A SERVICE OF KETTERING HEALTH GREENE ME

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1073948774, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
3
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
4
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
7
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 9 → 18 → 9 8 → 16 → 7 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 4 + 3 + 1 + 8 + 4 + 1 + 6 + 7 + 1 + 4 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1073948774.

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Family Medicine
29 KYLE DR
CEDARVILLE, OH 45314
Nurse Practitioner (Family)
29 KYLE DR
CEDARVILLE, OH 45314
Dietitian, Registered
29 KYLE DR
CEDARVILLE, OH 45314
Nurse Practitioner (Family)
29 KYLE DR
CEDARVILLE, OH 45314
Clinic/Center (Rural Health)
29 KYLE DR
CEDARVILLE, OH 45314

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073948774, enumerated as an "organization" on September 12, 2013.

The provider is located at 29 KYLE DR CEDARVILLE, OH 45314 and the phone number is (937) 766-2611.

Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.