Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Cleanslate Medical Group of Ohio LLC

Organization Addiction Medicine (Internal Medicine) Physician · NPI 1558800193

Cleanslate Medical Group of Ohio LLC is an Addiction Medicine (Internal Medicine) Physician in Moraine, Ohio. Registered with an NPI since 2017.

In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

4700 Springboro Pike Ste C
Moraine, OH 45439-1982
Phone: (937) 558-5100
Fax: (833) 279-7074
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction Medicine (Internal Medicine) Physician (primary) Taxonomy 207RA0401X

Record details

NPI number1558800193
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Matthew Smolarek — Cfo · (412) 999-5188
NPI enumeratedFebruary 15, 2017
Last updated in NPPESDecember 17, 2025
Certification dateDecember 17, 2025
Mailing address8 Cadillac Dr Ste 300, Brentwood, TN 37027-5337