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

Dr. John Paul Detherage III, MD

Individual provider Emergency Medicine Physician · NPI 1447833504

Dr. John Paul Detherage III, MD is an Emergency Medicine in Montgomery, Ohio. Graduated from Wright State University Boonshoft School of Medicine in 2021, 5 years ago. Practices with Orthocincy Orthopaedics and Sports Medicine PSC, a 164-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana, Kentucky and Ohio.

Years since qualifying
5
Trained at
Wright State University Boonshoft School of Medicine
Licensed in
IN, KY, OH
In the registry since
2021
Specialties on file
6
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

10506 Montgomery Rd Ste 209
Montgomery, OH 45242-4400
Phone: (513) 865-9040
Show map & directions

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

Additional practice locations (1)

  • 7910 Beechmont Ave, Cincinnati, OH 45255-4210 — (513) 232-2663

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 35150486 (OH)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 59124 (KY)
Sports Medicine (Emergency Medicine) Physician Taxonomy 207PS0010X · Licence 01098271A (IN)
Sports Medicine (Emergency Medicine) Physician Taxonomy 207PS0010X · Licence 35150486 (OH)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 01098271A (IN)
Sports Medicine (Emergency Medicine) Physician Taxonomy 207PS0010X · Licence 59124 (KY)

Record details

NPI number1447833504
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMay 5, 2021
Last updated in NPPESNovember 3, 2025
Certification dateNovember 3, 2025
Mailing address10506 Montgomery Rd Ste 209, Montgomery, OH 45242-4400

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Also practisesSPORTS MEDICINE
Medical schoolWRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Graduated 2021 (5 years in practice)
Group practice Orthocincy Orthopaedics And Sports Medicine Psc — 164 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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