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PMG VASCULAR IMAGING
NPI 1659726768
Radiology - Diagnostic Radiology in Moraine, OH

Active since April 26, 2016CLIA Certified · 4 labs
2912 SPRINGBORO RD, SUITE 201, MORAINE, OH 45439(937) 396-8137(937) 297-4868 Get Directions Write a Review

NPPES record last updated: April 26, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pmg Vascular Imaging NPPES

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

PMG VASCULAR IMAGING (NPI 1659726768) is a healthcare organization registered as a diagnostic radiology in Moraine, Ohio and active in the NPI registry since April 2016. The organization holds 4 active CLIA laboratory certificates and lists Susan J. Becker, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1659726768
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NamePROVIDENCE MEDICAL GROUP, INC.
Location Address2912 SPRINGBORO RD, SUITE 201Moraine, OH 45439-1674
Mailing Address2912 Springboro Rd, Suite 201Moraine, OH 45439-1674 · (937) 297-8999 · Fax (937) 298-9673
Phone(937) 396-8137
Fax(937) 297-4868
Organization SubpartNo
Authorized OfficialSusan J. BeckerChief Operating Officer · (937) 297-8999
Enumeration DateApril 26, 2016
✔ NPI 1659726768 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
2912 SPRINGBORO RD, Moraine, OH 45439
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Other Names 1

Doing Business AsPmg Vascular Imaging

Other Identifiers 2

Medicare PIN9326251OH
Medicaid2380294OH

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

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D1017593

Providence Medical Group Pmg Germantown · Germantown, OH
Active · expires May 8, 2028
CLIA Number36D1017593
Laboratory TypePhysician Office
Certificate Effective DateMay 9, 2026
Certificate Expiration DateMay 8, 2028
Laboratory DirectorAnn Smith
Laboratory Phone(937) 297-8999
Laboratory LocationProvidence Medical Group Pmg Germantown2320 Beechwood Drive, Germantown, OH 45327
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 36D2072442

Providence Medical Group Inc The Heights · Huber Heights, OH
Active · expires Jan 29, 2028
CLIA Number36D2072442
Laboratory TypePhysician Office
Certificate Effective DateJanuary 30, 2026
Certificate Expiration DateJanuary 29, 2028
Laboratory DirectorJennifer L. Machuca
Laboratory Phone(937) 297-8999
Laboratory LocationProvidence Medical Group Inc The Heights8701 Old Troy Pike Ste 10, Huber Heights, OH 45424
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 36D0938844

Providence Medical Group · Vandalia, OH
Active · expires Jun 6, 2027
CLIA Number36D0938844
Laboratory TypePhysician Office
Certificate Effective DateJune 7, 2025
Certificate Expiration DateJune 6, 2027
Laboratory DirectorSherry Howard
Laboratory Phone(937) 297-8999
Laboratory LocationProvidence Medical Group400 Corporate Center Drive, Vandalia, OH 45377
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 36D1023688

Providence Medical Laboratory · Dayton, OH
Active · expires Mar 9, 2027
CLIA Number36D1023688
Laboratory TypePhysician Office
Certificate Effective DateMarch 10, 2025
Certificate Expiration DateMarch 9, 2027
Laboratory DirectorDr. William E. Venanzi Jr
Laboratory Phone(937) 297-8999
Laboratory LocationProvidence Medical Laboratory2912 Springboro W Ste 201, Dayton, OH 45439
CLIA data matches this NPI record on: Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. LISA A RHODES CNP
Nurse Practitioner (Family)
2912 SPRINGBORO RD, SUITE 201
MORAINE, OH 45439
Montgomery County (937) 297-8999
DR. TERREN BURGESS KOLES M.D.
General Practice
2912 SPRINGBORO RD, SUITE
MORAINE, OH 45439
Montgomery County (513) 695-1468
PROVIDENCE MEDICAL GROUP
Podiatrist
2912 SPRINGBORO RD, SUITE 201
MORAINE, OH 45439
Montgomery County (937) 297-8999
PROVIDENCE HEALTH PARTNERS
Clinic/Center (Research)
2912 SPRINGBORO RD, SUITE 201
MORAINE, OH 45439
Montgomery County (937) 297-8999
MRS. JACQUELINE JUNE DAVIS NURSE PRACTITIONER
Nurse Practitioner (Family)
2912 SPRINGBORO RD
MORAINE, OH 45439
Montgomery County (937) 297-8999
PAULA A KIMPTON NP-C
Nurse Practitioner (Family)
2912 SPRINGBORO RD, SUITE 201
MORAINE, OH 45439
Montgomery County (937) 297-8999

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 Providence Medical Group, Inc.'s NPI number?

The NPI number for Providence Medical Group, Inc. is 1659726768. It was assigned to this organization in the NPPES registry on April 26, 2016. The provider is doing business as Pmg Vascular Imaging.

Where is Providence Medical Group, Inc. located?

Providence Medical Group, Inc. is located at 2912 Springboro Rd Suite 201, Moraine, OH 45439. The listed phone number is (937) 396-8137.

What is Providence Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Does Providence Medical Group, Inc. hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Providence Medical Group, Inc. accept?

Health plans from Anthem Blue Cross and Blue Shield list Providence 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 Providence Medical Group, Inc. was last updated on April 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.