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PROVIDENCE MEDICAL GROUP
NPI 1972533149
Family Medicine in Dayton, OH

Active since July 04, 2006
2912 SPRINGBORO RD W, SUITE 201, DAYTON, OH 45439(937) 297-8999(937) 297-4852 Get Directions Write a Review

NPPES record last updated: October 19, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Providence Medical Group NPPES

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

PROVIDENCE MEDICAL GROUP (NPI 1972533149) is a healthcare organization registered as a family medicine in Dayton, Ohio and active in the NPI registry since July 2006. The organization lists Susan J Becker, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1972533149
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePROVIDENCE MEDICAL GROUP
Location Address2912 SPRINGBORO RD W, SUITE 201Dayton, OH 45439-1674
Mailing Address2912 Springboro Rd W, Suite 201Dayton, OH 45439-1674 · (937) 297-8999 · Fax (937) 297-4852
Phone(937) 297-8999
Fax(937) 297-4852
Organization SubpartNo
Authorized OfficialSusan J BeckerChief Operating Officer · (937) 297-8999
Enumeration DateJuly 4, 2006
Last NPPES UpdateOctober 19, 2022
NPPES CertifiedOctober 19, 2022
✔ NPI 1972533149 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 15

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
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.
Also ListedDietitian, RegisteredTaxonomy 133V00000X
Also ListedRegistered Nurse · Diabetes EducatorTaxonomy 163WD0400X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedPediatricsTaxonomy 208000000X
Also ListedSurgeryTaxonomy 208600000X
Also ListedUrology · Urogynecology and Reconstructive Pelvic SurgeryTaxonomy 2088F0040X
Also ListedColon & Rectal SurgeryTaxonomy 208C00000X
Also ListedGeneral PracticeTaxonomy 208D00000X
Also ListedClinical Medical LaboratoryTaxonomy 291U00000X
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X
Also ListedNurse PractitionerTaxonomy 363L00000X · License 1313008 (OH)
Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X
Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X
2912 SPRINGBORO RD W, Dayton, OH 45439
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Other Identifiers 1

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, CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Providence Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

49

Medicare enrollment records show 49 clinicians reassign Medicare billing to Providence Medical Group, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 25 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 5

Nurse Practitioner32
Family Practice14
Colorectal Surgery (Proctology)1
Pediatric Medicine1
Rheumatology1

Nearest to this location (20)

See all 49
Sara Whitlock, CFNP
Nurse Practitioner
NPI 1710153556
2912 SPRINGBORO W STE 201
Moraine, OH 45439
(937) 297-8999
✔ PECOSSame address
Carrie Cain, CNP
Nurse Practitioner
NPI 1396402905
4441 FAR HILLS AVE
Kettering, OH 45429
(937) 298-7351
✔ PECOS✔ Accepts Medicare3.5 mi
Rian Kyles-Stewart
Nurse Practitioner
NPI 1114407061
40 W 2ND ST
Dayton, OH 45402
(937) 694-5925
✔ PECOS✔ Accepts Medicare3.6 mi
Chelsea Ferree, FNP-C
Nurse Practitioner
NPI 1588231369
1 CHILDRENS PLZ
Dayton, OH 45404
(937) 641-4000
✔ PECOS5.0 mi
Lori Milliron, CPNP
Nurse Practitioner
NPI 1043410830
1010 VALLEY ST
Dayton, OH 45404
(937) 641-4000
✔ PECOS5.5 mi
Jeffrey Gleick, MD
Family Practice
NPI 1760487599
1989 MIAMISBURG CENTERVILLE RD SUITE 301
Centerville, OH 45459
(937) 434-7353
✔ PECOS✔ Accepts Medicare5.5 mi
Inna Bair, CNP
Nurse Practitioner
NPI 1063076412
1989 MIAMISBURG CENTERVILLE RD STE 301
Centerville, OH 45459
(937) 434-7353
✔ PECOS✔ Accepts Medicare5.5 mi
Mijanou Marretta-Lewis, FNP-C
Nurse Practitioner
NPI 1235627142
1989 MIAMISBURG CENTERVILLE RD STE 301
Centerville, OH 45459
(937) 434-7353
✔ PECOS✔ Accepts Medicare5.5 mi
William Venanzi, MD
Rheumatology
NPI 1174505937
1989 MIAMISBURG CENTERVILLE RD STE 301
Centerville, OH 45459
(937) 434-7353
✔ PECOS✔ Accepts Medicare5.5 mi
Lori Whitehead, APRN-CNP
Nurse Practitioner
NPI 1952116352
1989 MIAMISBURG CENTERVILLE RD STE 301
Centerville, OH 45459
(937) 434-7353
✔ PECOS✔ Accepts Medicare5.5 mi
Mollie Trupp, MSN, APRN, CNP
Nurse Practitioner
NPI 1861228504
1181 E LINDEN AVE
Miamisburg, OH 45342
(937) 668-2465
✔ PECOS✔ Accepts Medicare6.0 mi
Kathleen Gutman, MD
Pediatric Medicine
NPI 1639134992
1516 YANKEE PARK PL
Dayton, OH 45458
(937) 438-1115
✔ PECOS6.2 mi
Jennifer Goodin, APRN
Nurse Practitioner
NPI 1215687199
75 SYLVANIA DR
Dayton, OH 45440
(937) 320-5050
✔ PECOS✔ Accepts Medicare6.8 mi
Barbara Bennett, D.O.
Family Practice
NPI 1003819525
38 WOODCROFT TRL
Beavercreek, OH 45430
(937) 427-3333
✔ PECOS✔ Accepts Medicare7.1 mi
Shelby Prater
Family Practice
NPI 1447077433
38 WOODCROFT TRL
Beavercreek, OH 45430
(937) 427-3333
✔ PECOS✔ Accepts Medicare7.1 mi
Darin Green, DO
Colorectal Surgery (Proctology)
NPI 1811043664
4403 W FRANKLIN ST STE B
Bellbrook, OH 45305
(937) 222-2096
✔ PECOS✔ Accepts Medicare8.1 mi
Harold Edmiston, DO
Family Practice
NPI 1881728905
2320 BEECHWOOD DR
Germantown, OH 45327
(937) 895-4092
✔ PECOS✔ Accepts Medicare8.5 mi
James Fisco, D.O.
Family Practice
NPI 1245233766
70 REMICK BLVD
Springboro, OH 45066
(937) 885-0701
✔ PECOS✔ Accepts Medicare9.2 mi
Kevin Carter, DO
Family Practice
NPI 1053403329
2633 COMMONS BLVD STE 110
Beavercreek, OH 45431
(937) 705-6747
✔ PECOS✔ Accepts Medicare9.4 mi
Rebecca Cherry, MD
Family Practice
NPI 1285622043
2633 COMMONS BLVD STE 120
Beavercreek, OH 45431
(937) 427-7540
✔ PECOS9.4 mi
See all 49 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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's NPI number?

The NPI number for Providence Medical Group is 1972533149. It was assigned to this organization in the NPPES registry on July 4, 2006.

Where is Providence Medical Group located?

Providence Medical Group is located at 2912 Springboro Rd W Suite 201, Dayton, OH 45439. The listed phone number is (937) 297-8999.

What is Providence Medical Group's specialty?

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

Is Providence Medical Group enrolled in Medicare?

Yes. Providence Medical Group is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Providence Medical Group?

According to the CMS Revalidation Reassignment List (October 2026 release), 49 clinicians in 5 Medicare specialties reassign their Medicare billing to Providence Medical Group. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (32), Family Practice (14) and Colorectal Surgery (Proctology) (1). Of these, 1 practice at this address and 25 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Providence Medical Group accept?

Health plans from Anthem Blue Cross and Blue Shield and CareSource list Providence Medical Group 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 was last updated on October 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.