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

Kettering Independent Medical Group Inc

Organization Family Medicine Physician · NPI 1629387865

Kettering Independent Medical Group Inc is a Family Medicine Physician in Miamisburg, Ohio. Registered with an NPI since 2010.

In the registry since
2010
Specialties on file
6
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1 Prestige Pl Ste 910
Miamisburg, OH 45342-3794
Phone: (937) 762-1629
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X
Family Medicine Physician Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Cardiovascular Disease Physician Taxonomy 207RC0000X
Obstetrics & Gynecology Physician Taxonomy 207V00000X
Surgery Physician Taxonomy 208600000X

Record details

NPI number1629387865
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Ko — Chief Financial Officer · (937) 395-8522
Other names Kettering Specialty Care, Inc.; Kettering Specialty Care, Inc.
NPI enumeratedOctober 6, 2010
Last updated in NPPESMarch 27, 2023
Certification dateMarch 27, 2023
Mailing address1 Prestige Pl Ste 550, Miamisburg, OH 45342-6115

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