KETTERING INDEPENDENT MEDICAL GROUP INC
NPI 1629387865
Orthopaedic Surgery in Miamisburg, OH

Active since October 06, 2010
1 PRESTIGE PL, SUITE 910, MIAMISBURG, OH 45342(937) 762-1629 Get Directions Write a Review

NPPES record last updated: March 27, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 27, 2023, Mar 13, 2023, Jan 25, 2023 and 2 more (5 updates tracked since 2017).

About Kettering Independent Medical Group Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KETTERING INDEPENDENT MEDICAL GROUP INC (NPI 1629387865), doing business as Kettering Specialty Care, Inc., is a healthcare organization registered as an orthopaedic surgery in Miamisburg, Ohio and active in the NPI registry since October 2010. The organization lists Timothy Y Ko, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1629387865
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameKETTERING INDEPENDENT MEDICAL GROUP INC
Location Address1 PRESTIGE PL, SUITE 910Miamisburg, OH 45342-3794
Mailing Address1 Prestige Pl Ste 550Miamisburg, OH 45342-6115 · (937) 762-1310 · Fax (937) 522-8068
Organization SubpartNo
Authorized OfficialTimothy Y KoChief Financial Officer · (937) 395-8522
Enumeration DateOctober 6, 2010
Last NPPES UpdateMarch 27, 20235 updates tracked since enumeration
NPPES CertifiedMarch 27, 2023
✔ NPI 1629387865 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedSurgeryTaxonomy 208600000X
1 PRESTIGE PL, Miamisburg, OH 45342

Other Names 1

Former Legal Business NameKettering Specialty Care, Inc.

Other Identifiers 1

Medicaid0207472OH

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kettering Independent Medical Group Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

983

Medicare enrollment records show 983 clinicians reassign Medicare billing to Kettering Independent Medical Group Inc, which bills Medicare for the services they deliver. Of these, 440 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 45

Nurse Practitioner240
Neurology166
Hospitalist90
Obstetrics/Gynecology68
Internal Medicine50
General Surgery42
Cardiovascular Disease (Cardiology)40
Urology28
37 other specialties259

Nearest to this location (20)

See all 983
Nurse Practitioner
NPI 1669196150
415 BYERS RD STE 300
Miamisburg, OH 45342
(937) 866-2494
✔ PECOS✔ Accepts Medicare0.4 mi
Family Practice
NPI 1790762854
415 BYERS RD STE 300
Miamisburg, OH 45342
(937) 866-2494
✔ PECOS✔ Accepts Medicare0.4 mi
Obstetrics/Gynecology
NPI 1649257395
2591 MIAMISBURG CENTERVILLE RD STE 201
Centerville, OH 45459
(937) 439-5252
✔ PECOS✔ Accepts Medicare0.7 mi
Obstetrics/Gynecology
NPI 1386621027
2591 MIAMISBURG CENTERVILLE RD STE 201
Dayton, OH 45459
(937) 439-5252
✔ PECOS✔ Accepts Medicare0.7 mi
Nurse Practitioner
NPI 1629517727
2591 MIAMISBURG CENTERVILLE RD STE 201
Centerville, OH 45459
(937) 439-5252
✔ PECOS✔ Accepts Medicare0.7 mi
Nurse Practitioner
NPI 1962786731
2591 MIAMISBURG CENTERVILLE RD STE 201
Dayton, OH 45459
(937) 439-5252
✔ PECOS✔ Accepts Medicare0.7 mi
Nurse Practitioner
NPI 1598179863
9049 SPRINGBORO PIKE
Miamisburg, OH 45342
(937) 759-0545
✔ PECOS✔ Accepts Medicare1.0 mi
Nurse Practitioner
NPI 1336868827
9049 SPRINGBORO PIKE
Miamisburg, OH 45342
(937) 759-0545
✔ PECOS✔ Accepts Medicare1.0 mi
Pain Management
NPI 1043259971
4000 MIAMISBURG CENTERVILLE RD
Miamisburg, OH 45342
(937) 384-4511
✔ PECOS✔ Accepts Medicare1.1 mi
Orthopedic Surgery
NPI 1740314954
4000 MIAMISBURG CENTERVILLE RD STE. 230
Miamisburg, OH 45342
(937) 433-5309
✔ PECOS✔ Accepts Medicare1.1 mi
Nurse Practitioner
NPI 1407956790
4000 MIAMISBURG CENTERVILLE RD STE 410
Miamisburg, OH 45342
(937) 384-4511
✔ PECOS✔ Accepts Medicare1.1 mi
Certified Clinical Nurse Specialist (CNS)
NPI 1770942880
4000 MIAMISBURG CENTERVILLE RD STE 200
Miamisburg, OH 45342
(937) 395-8439
✔ PECOS✔ Accepts Medicare1.1 mi
Urology
NPI 1457433831
4000 MIAMISBURG CENTERVILLE RD STE 450
Miamisburg, OH 45342
(937) 560-2011
✔ PECOS1.1 mi
Cardiovascular Disease (Cardiology)
NPI 1114909744
4000 MIAMISBURG-CENTERVILLE RD. STE 100
Miamisburg, OH 45342
(937) 866-0637
✔ PECOS✔ Accepts Medicare1.1 mi
General Surgery
NPI 1730599366
4000 MIAMISBURG CENTERVILLE RD STE 420
Miamisburg, OH 45342
(937) 439-4145
✔ PECOS✔ Accepts Medicare1.1 mi
Interventional Cardiology
NPI 1558334581
4000 MIAMISBURG CENTERVILLE RD SUITE 100
Miamisburg, OH 45342
(937) 866-0637
✔ PECOS✔ Accepts Medicare1.1 mi
Hospitalist
NPI 1194952879
4000 MIAMISBURG CENTERVILLE RD SUITE 450
Miamisburg, OH 45342
(937) 439-3600
✔ PECOS✔ Accepts Medicare1.1 mi
Internal Medicine
NPI 1902434467
2960 FERNDOWN DR
Miamisburg, OH 45342
(937) 886-5510
✔ PECOS✔ Accepts Medicare1.2 mi
Registered Dietitian or Nutrition Professional
NPI 1285247593
1989 MIAMISBURG CENTERVILLE RD STE 201
Dayton, OH 45459
(937) 401-6276
✔ Accepts Medicare1.4 mi
Obstetrics/Gynecology
NPI 1508842600
1989 MIAMISBURG CENTERVILLE RD SUITE 302
Centerville, OH 45459
(937) 528-6890
✔ PECOS✔ Accepts Medicare1.4 mi
See all 983 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kettering Independent Medical Group Inc's NPI number?

The NPI number for Kettering Independent Medical Group Inc is 1629387865. It was assigned to this organization in the NPPES registry on October 6, 2010. The provider was formerly known as Kettering Specialty Care, Inc..

Where is Kettering Independent Medical Group Inc located?

Kettering Independent Medical Group Inc is located at 1 Prestige Pl Suite 910, Miamisburg, OH 45342. The listed phone number is (937) 762-1629.

What is Kettering Independent Medical Group Inc's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Kettering Independent Medical Group Inc enrolled in Medicare?

Yes. Kettering Independent Medical Group Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kettering Independent Medical Group Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 983 clinicians in 45 Medicare specialties reassign their Medicare billing to Kettering Independent Medical Group Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (240), Neurology (166) and Hospitalist (90). Of these, 440 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Kettering Independent Medical Group Inc accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Molina Healthcare list Kettering Independent Medical Group Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kettering Independent Medical Group Inc was last updated on March 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.