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KETTERING VASCULAR SURGERY ASSOCIATES
NPI 1730461047
Surgery in Beavercreek, OH

Active since September 13, 2011CLIA 36D2240345 · Waiver
2141 N FAIRFIELD RD, SUITE B, BEAVERCREEK, OH 45431(937) 458-0085(937) 458-0212 Get Directions Write a Review

NPPES record last updated: September 9, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Kettering Vascular Surgery Associates NPPES

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

KETTERING VASCULAR SURGERY ASSOCIATES (NPI 1730461047) is a healthcare organization registered as a surgery in Beavercreek, Ohio and active in the NPI registry since September 2011. The organization holds a CLIA Waiver certificate valid through October 18, 2027 and lists Daniel D Haibach, Director Business Development, as its authorized official.

NPPES Registry Identity

NPI1730461047
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NameALLIANCE PHYSICIAN INC
Location Address2141 N FAIRFIELD RD, SUITE BBeavercreek, OH 45431-2579
Mailing Address2110 Leiter RdMiamisburg, OH 45342-3660 · (937) 384-4838 · Fax (937) 384-4845
Phone(937) 458-0085
Fax(937) 458-0212
Organization SubpartYes
Authorized OfficialDaniel D HaibachDirector Business Development · (937) 558-3222
Enumeration DateSeptember 13, 2011
Last NPPES UpdateSeptember 9, 2013
✔ NPI 1730461047 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Also ListedSurgery · Vascular SurgeryTaxonomy 2086S0129X
2141 N FAIRFIELD RD, Beavercreek, OH 45431
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Other Names 1

Doing Business AsKettering Vascular Surgery Associates

Other Identifiers 2

Medicaid2712872OH
Medicare PIN9306898OH

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

CLIA Laboratory Certificates CMS CLIA 10

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 36D2240345

Kettering Health Medical Group Pediatrics · Beavercreek, OH
Active · expires Oct 18, 2027
CLIA Number36D2240345
Laboratory TypePhysician Office
Certificate Effective DateOctober 19, 2025
Certificate Expiration DateOctober 18, 2027
Laboratory DirectorKrista Gelford
Laboratory Phone(937) 427-2112
Laboratory LocationKettering Health Medical Group Pediatrics2141 N Fairfield Rd, Suite C, Beavercreek, OH 45431
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 36D0681003

Kettering Health Medical Group Urology · Miamisburg, OH
Active · expires Apr 16, 2027
CLIA Number36D0681003
Laboratory TypePhysician Office
Certificate Effective DateApril 17, 2025
Certificate Expiration DateApril 16, 2027
Laboratory DirectorRaymond Scott Russell
Laboratory Phone(937) 560-2011
Laboratory LocationKettering Health Medical Group Urology4000 Miamisburg-Centerville Rd Suite 450, Miamisburg, OH 45342
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 36D2055835

Kettering Health Medical Group Urology · Beavercreek, OH
Active · expires Mar 17, 2027
CLIA Number36D2055835
Laboratory TypePhysician Office
Certificate Effective DateMarch 18, 2025
Certificate Expiration DateMarch 17, 2027
Laboratory DirectorJorge Arzola
Laboratory Phone(937) 294-1489
Laboratory LocationKettering Health Medical Group Urology3535 Pentagon Blvd Ste 320, Beavercreek, OH 45431
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 36D2162334

Kettering Health Dayton Cancer Care Soin - Waived Testing Lab · Beavercreek, OH
Active · expires Feb 19, 2027
CLIA Number36D2162334
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateFebruary 20, 2025
Certificate Expiration DateFebruary 19, 2027
Laboratory DirectorJason Meyer
Laboratory Phone(937) 281-3806
Laboratory LocationKettering Health Dayton Cancer Care Soin - Waived Testing Lab3535 Pentagon Park Blvd Suite 400, Cla Room, Beavercreek, OH 45431
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 36D2109848

Kettering Health Medical Group Primary Care · Beavercreek, OH
Active · expires Jan 22, 2027
CLIA Number36D2109848
Laboratory TypePhysician Office
Certificate Effective DateJanuary 23, 2025
Certificate Expiration DateJanuary 22, 2027
Laboratory DirectorJohn C. Sefton
Laboratory Phone(937) 490-0123
Laboratory LocationKettering Health Medical Group Primary Care2510 Commons Blvd, Suite 110, Beavercreek, OH 45431
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 36D1006865

Kettering Health Medical Group Ob-Gyn · Beavercreek, OH
Active · expires Dec 2, 2026
CLIA Number36D1006865
Laboratory TypePhysician Office
Certificate Effective DateDecember 3, 2024
Certificate Expiration DateDecember 2, 2026
Laboratory DirectorSteven Crawford
Laboratory Phone(937) 429-7350
Laboratory LocationKettering Health Medical Group Ob-Gyn3535 Pentagon Blvd, #220, Beavercreek, OH 45431
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

DAYTON CARDIOLOGY CONSULT
Specialist
2141 N FAIRFIELD RD
BEAVERCREEK, OH 45431
Greene County (937) 223-3053
DR. JACOB CARMEN YANNETTA III D.O.
Surgery (Vascular Surgery)
2141 N FAIRFIELD RD, STE. B
BEAVERCREEK, OH 45431
Greene County (937) 458-0025
REBECCA ANNE PERRY CNP
Nurse Practitioner (Adult Health)
2141 N FAIRFIELD RD, STE B
BEAVERCREEK, OH 45431
Greene County (419) 575-5642

Frequently Asked Questions

What is ALLIANCE PHYSICIAN INC's NPI number?

The NPI number assigned to this healthcare provider is 1730461047, enumerated as an "organization" on September 13, 2011.

Where is the provider located?

The provider is located at 2141 N FAIRFIELD RD SUITE B BEAVERCREEK, OH 45431 and the phone number is (937) 458-0085.

What is the provider's specialty?

Surgery with taxonomy code 208600000X.

What insurance does ALLIANCE PHYSICIAN INC accept?

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.