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PROVIDENCE SURGERY CENTER@ CORNERSTONE
NPI 1821373945
Obstetrics & Gynecology in Centerville, OH

Active since October 20, 2011CLIA 36D0350228 · Microscopy
7756 WASHINGTON VILLAGE DR, SUITE 125, CENTERVILLE, OH 45459(937) 297-8999 Get Directions Write a Review

NPPES record last updated: October 20, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Providence Surgery Center@ Cornerstone NPPES

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

PROVIDENCE SURGERY CENTER@ CORNERSTONE (NPI 1821373945) is a healthcare organization registered as an obstetrics & gynecology in Centerville, Ohio and active in the NPI registry since October 2011. The organization holds a CLIA Microscopy certificate valid through March 26, 2028 and lists Susan J Becker, Chief Operations Officer, as its authorized official.

NPPES Registry Identity

NPI1821373945
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NamePROVIDENCE MEDICAL GROUP INC
Location Address7756 WASHINGTON VILLAGE DR, SUITE 125Centerville, OH 45459-3999
Mailing Address2912 Springboro Rd, Suite 201Moraine, OH 45439-1674 · (937) 297-8999
Phone(937) 297-8999
Organization SubpartYesParent: Providence Medical Group
Authorized OfficialSusan J BeckerChief Operations Officer · (937) 297-8999
Enumeration DateOctober 20, 2011
✔ NPI 1821373945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in OH · 005030
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
7756 WASHINGTON VILLAGE DR, Centerville, OH 45459
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Other Names 1

Doing Business AsProvidence Surgery Center@ Cornerstone

Other Identifiers 2

Medicare PINPR9326251OH
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

CLIA Laboratory Certificates CMS CLIA

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 for Provider-Performed Microscopy Procedures (PPMP) 36D0350228

Providence Medical Group · Centerville, OH
Active · expires Mar 26, 2028
CLIA Number36D0350228
Laboratory TypePhysician Office
Certificate Effective DateMarch 27, 2026
Certificate Expiration DateMarch 26, 2028
Laboratory DirectorJeffrey J. Gleick
Laboratory Phone(937) 434-7353
Laboratory LocationProvidence Medical Group1989 Miamisburg Centerville Rd Suite 301, Centerville, OH 45459
CLIA data matches this NPI record on: Name
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.

Other Providers at the Same Location NPPES 5

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

ALLIANCE PHYSICIANS INC
Obstetrics & Gynecology (Urogynecology and Reconstructive Pelvic Surgery)
7756 WASHINGTON VILLAGE DR, SUITE 135
CENTERVILLE, OH 45459
Montgomery County (937) 436-9825
PHYSICIAN SLEEP DIAGNOSTIC CENTERS, LLC
Clinic/Center (Sleep Disorder Diagnostic)
7756 WASHINGTON VILLAGE DR, SUITE A
DAYTON, OH 45459
Montgomery County (937) 425-0035
QUESTCARE SLEEP DIAGNOSTICS, LLC
Clinic/Center (Sleep Disorder Diagnostic)
7756 WASHINGTON VILLAGE DR, STE A
CENTERVILLE, OH 45459
Montgomery County (937) 425-0035
ALLIANCE PHYSICIAN INC
Obstetrics & Gynecology (Gynecology)
7756 WASHINGTON VILLAGE DR, SUITE 135
CENTERVILLE, OH 45459
Montgomery County (937) 436-9825
SARAH M KING CNP
Nurse Practitioner (Women's Health)
7756 WASHINGTON VILLAGE DR, SUITE 135
CENTERVILLE, OH 45459
Montgomery County (937) 531-0190

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 1821373945. It was assigned to this organization in the NPPES registry on October 20, 2011. The provider is doing business as Providence Surgery Center@ Cornerstone.

Where is Providence Medical Group Inc located?

Providence Medical Group Inc is located at 7756 Washington Village Dr Suite 125, Centerville, OH 45459. The listed phone number is (937) 297-8999.

What is Providence Medical Group Inc's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Does Providence Medical Group Inc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 36D0350228) is associated with this NPI, valid through March 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Providence Medical Group Inc was last updated on October 20, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.