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Providence Medical Group

Clinical Medical Laboratory in Moraine, OH · enumerated 2008 · authorized official Shirley Pfeiffer, Credentialing Coordinator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1760658371

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Registry record

Entity type Organization (Type 2)
Legal business name Providence Medical Group
Other name <Unavail>
Parent organization Providence Medical Group
Practice address 2912 Springboro W, Suite 203, Moraine, OH, 45439
Phone (937) 297-8999
Fax (937) 298-9673
Enumeration date May 3, 2008
Last updated in NPPES Nov 26, 2014

Taxonomy & classification

291U00000X Clinical Medical Laboratory Laboratories · License 016189 (OH) Primary

Authorized official

Name Shirley Pfeiffer
Title Credentialing Coordinator
Phone (937) 297-8999

Other identifiers

Identifier Type State Issuer
2380294 Medicaid OH -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2014-11-26. Verify at npiregistry.cms.hhs.gov.
Where is Providence Medical Group located?
The practice location on file with NPPES is in Moraine, OH.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-11-26.