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BEAVERTOWN CLINIC INC
NPI 1902803703
Family Medicine in Kettering, OH

Active since July 07, 2005CLIA 36D0349842 · Microscopy
3017 WILMINGTON PIKE, KETTERING, OH 45429(937) 294-2555(937) 294-3211 Get Directions Write a Review

NPPES record last updated: February 23, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Beavertown Clinic Inc NPPES

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

BEAVERTOWN CLINIC INC (NPI 1902803703) is a healthcare organization registered as a family medicine in Kettering, Ohio and active in the NPI registry since July 2005. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists Bernard J Rose, Physician, as its authorized official.

NPPES Registry Identity

NPI1902803703
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBEAVERTOWN CLINIC INC
Location Address3017 WILMINGTON PIKEKettering, OH 45429-4169
Mailing Address3017 Wilmington PikeKettering, OH 45429-4169 · (937) 294-2555 · Fax (937) 294-3211
Phone(937) 294-2555
Fax(937) 294-3211
Organization SubpartNo
Authorized OfficialBernard J RosePhysician · (937) 294-2555
Enumeration DateJuly 7, 2005
Last NPPES UpdateFebruary 23, 2010
✔ NPI 1902803703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in OH · 35052219R✔ Licensed in OH · 35058825R
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3017 WILMINGTON PIKE, Kettering, OH 45429
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Other Identifiers 5

Medicare UPINA17231OH
Medicare ID-Type UnspecifiedR00698961OH · Dr K Rose Individual Pi
MedicaidR00609981OH
Medicare UPINE97912OH
Medicare ID-Type UnspecifiedBE9266611OH · Group Id

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 Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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) 36D0349842

Beavertown Clinic Inc · Dayton, OH
Active · expires Aug 31, 2026
CLIA Number36D0349842
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorKarl G. Rose
Laboratory Phone(937) 294-2555
Laboratory LocationBeavertown Clinic Inc3017 Wilmington Pike, Dayton, OH 45429
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.

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.

DR ROSE & WARD MD INC
Ophthalmology
3017 WILMINGTON PIKE, LOWER LEVEL
DAYTON, OH 45429
Montgomery County (937) 299-9700
DR. STEPHEN DENNIS WARD MD
Ophthalmology
3017 WILMINGTON PIKE, LOWER LEVEL
DAYTON, OH 45429
Montgomery County (937) 299-9700
DR. KARL G ROSE M.D.
Family Medicine
3017 WILMINGTON PIKE
KETTERING, OH 45429
Montgomery County (937) 294-2555
DR. CATHERINE M ROSE MD
Ophthalmology
3017 WILMINGTON PIKE, LOWER LEVEL
DAYTON, OH 45429
Montgomery County (937) 299-9700
DR. BERNARD J ROSE M.D.
Family Medicine
3017 WILMINGTON PIKE
KETTERING, OH 45429
Montgomery County (937) 294-2555
KARL G. ROSE M.D., INC.
Family Medicine
3017 WILMINGTON PIKE
KETTERING, OH 45429
Montgomery County (937) 294-2555

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 Beavertown Clinic Inc's NPI number?

The NPI number for Beavertown Clinic Inc is 1902803703. It was assigned to this organization in the NPPES registry on July 7, 2005.

Where is Beavertown Clinic Inc located?

Beavertown Clinic Inc is located at 3017 Wilmington Pike, Kettering, OH 45429. The listed phone number is (937) 294-2555.

What is Beavertown Clinic Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Beavertown Clinic Inc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 36D0349842) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Beavertown Clinic Inc accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Beavertown Clinic 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 Beavertown Clinic Inc was last updated on February 23, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.