PROVIDENCE MEDICAL GROUP
NPI 1811304595
Podiatrist in Moraine, OH
NPI Status: Active since July 15, 2014
Contact Information
2912 SPRINGBORO RD
SUITE 201
MORAINE, OH
ZIP 45439
Phone: (937) 297-8999
Fax: (937) 297-4852
- Organization
- Podiatrist
- CLIA Number: 36D2072442
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-29-2026
About PROVIDENCE MEDICAL GROUP
This page provides the complete NPI Profile along with additional information for Providence Medical Group, a provider established in Moraine, Ohio operating as a Podiatrist. The healthcare provider is registered in the NPI registry with number 1811304595 assigned on July 2014. The practitioner's primary taxonomy code is 213E00000X with license number 36.003657 (OH). The provider is registered as an organization and their NPI record was last updated 12 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Susan Becker Coo (Chief Operating Officer)
- NPI
- 1811304595
- Provider Name
- PROVIDENCE MEDICAL GROUP
- Entity Type
- Organization
- Location Address
- 2912 SPRINGBORO RD SUITE 201 MORAINE, OH 45439
- Location Phone
- (937) 297-8999
- Location Fax
- (937) 297-4852
- Mailing Address
- 2912 SPRINGBORO RD SUITE 201 MORAINE, OH 45439
- Mailing Phone
- (937) 297-8999
- Mailing Fax
- (937) 297-4852
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 07-15-2014
- Last Update Date
- 10-28-2014
- Code Navigator
A podiatrist like Providence Medical Group provides medical and surgical care for people with foot, ankle, and lower leg issues. Podiatrists treat foot and ankle ailments like calluses, ingrown toenails, heel spurs, arthritis, congenital foot deformities, foot problems associated with diabetes and arch problems.
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
Podiatrist
- Taxonomy Code
- 213E00000X
- Type
- Podiatric Medicine & Surgery Service Providers
- License No.
- 36.003657
- License State
- OH
- Taxonomy Description
- A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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.
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 |
|---|---|---|---|
| 0083030 | MEDICAID (05) | OH | |
| 1285952937 | OTHER (01) | OH | INDIVIDUAL NPI |
| 2380294 | MEDICAID (05) | OH | |
| H198263 | MEDICARE PIN (08) | 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
- 36D2072442
- Facility Type
- Physician Office
- Certificate Effective Date
- January 30, 2024
- Certificate Expiration Date
- January 29, 2026
- Laboratory Director
- JENNIFER L. MACHUCA
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Providence Medical Group in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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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 1811304595, we treat the final digit (5) 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 7 providers are registered at the same or a nearby location.
MORAINE, OH 45439
MORAINE, OH 45439
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1811304595, enumerated as an "organization" on July 15, 2014.
The provider is located at 2912 SPRINGBORO RD SUITE 201 MORAINE, OH 45439 and the phone number is (937) 297-8999.
Podiatrist with taxonomy code 213E00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
