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Providence Medical Group

Podiatrist in Moraine, OH · enumerated 2014 · authorized official Susan Becker, Chief Operating Officer.

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

National Provider Identifier

1811304595

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Registry record

Entity type Organization (Type 2)
Legal business name Providence Medical Group
Parent organization Providence Podiatry
Practice address 2912 Springboro Rd, Suite 201, Moraine, OH, 45439
Phone (937) 297-8999
Fax (937) 297-4852
Enumeration date Jul 15, 2014
Last updated in NPPES Oct 28, 2014

Taxonomy & classification

213E00000X Podiatrist Podiatric Medicine & Surgery Service Providers · License 36.003657 (OH) Primary

Authorized official

Name Susan Becker
Title Chief Operating Officer
Phone (937) 297-8999

Other identifiers

Identifier Type State Issuer
1285952937 Other OH INDIVIDUAL NPI
2380294 Medicaid OH -
0083030 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

What type of organization is Providence Medical Group?
Providence Medical Group is registered in NPPES as a Podiatrist (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-10-28.