KETTERING PHYSIATRISTS, INC. – Physical Medicine & Rehabilitation Physician, NPI 1902893035

KETTERING PHYSIATRISTS, INC. is a healthcare provider. based in Kettering, Ohio. specializing in Physical Medicine & Rehabilitation Physician. The organization holds a License No. 35038579P (OH). The NPI Number for KETTERING PHYSIATRISTS, INC. is 1902893035

Main info

Organization
Name
KETTERING PHYSIATRISTS, INC.
NPI
1902893035
Phone
(937) 395-8666
Address
3535 SOUTHERN BLVD
Authorized Official
JOHN PETTY PRESIDENT MD
Enumeration Date
4 October 2005
Last Update Date
22 August 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for KETTERING PHYSIATRISTS, INC.

  • Kettering Medical Center, 3535, Southern Boulevard, Kettering, Montgomery County, Ohio, 45429, United States

    KETTERING, OH 454291221

    Phone: (937) 395-8666

    Fax: (937) 395-8090

    Type: Location

  • PO BOX 750245

    DAYTON, OH 454750245

    Phone: (937) 438-9500

    Fax: (937) 438-9075

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-09-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20050920001421OClinic/Group PracticeOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 45429)

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Reviews

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Frequently asked questions

What is KETTERING PHYSIATRISTS, INC.'s NPI number?
KETTERING PHYSIATRISTS, INC.'s NPI is 1902893035 — the number used across U.S. healthcare to identify this provider.
Is there an active status for KETTERING PHYSIATRISTS, INC.?
For scheduling context, KETTERING PHYSIATRISTS, INC. is shown as active in the registry.
How would a patient describe KETTERING PHYSIATRISTS, INC.'s focus?
For KETTERING PHYSIATRISTS, INC., the primary taxonomy reads as Physical Medicine & Rehabilitation Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with KETTERING PHYSIATRISTS, INC.?
Directory geography for KETTERING PHYSIATRISTS, INC. centers on Kettering, Ohio.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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