Individual provider Active NPI

Kaitlyn Pollock, D.O.

  • Psychiatry Physician
  • Xenia, OH
National Provider Identifier
1033529953
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
34013449 Issued in OH
Practice address
452 W Market St
Xenia, OH 45385-2815
Phone
(937) 376-8700
NPI assigned
Apr 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 34013449 OH Primary

Addresses

Primary practice location

452 W Market St
Xenia, OH 45385-2815

Mailing address

452 W Market St
Xenia, OH 45385-2815
Phone (937) 376-8700

Other practice location 1

627 S Edwin C Moses Blvd
Dayton, OH 45435-0001
Phone (937) 223-8840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210819003208 OH Practitioner - Psychiatry 2365662863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Ohio University, College of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TCN Behavioral Health Services, Inc.Group PAC ID 8224011135, 20 clinicians

Practice addresses (Care Compare)

118 Maple Ave
Bellefontaine, OH 43311-1619
Phone (937) 376-8700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
TCN Behavioral Health Services, Inc. CurrentSince Aug 13, 2021 Accepting new patients

Locations

118 Maple Ave
Bellefontaine, OH 43311
Phone (937) 599-1975

1522 E US Highway 36
#A
Urbana, OH 43078
Phone (937) 471-2956

452 W Market St
Xenia, OH 45385
Phone (937) 376-8744

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1033529953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 W MARKET ST",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453852815",
            "telephone_number": "937-376-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 W MARKET ST",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453852815",
            "telephone_number": "937-376-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "627 S Edwin C Moses Blvd",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454350001",
            "country_code": "US",
            "telephone_number": "937-223-8840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLLOCK",
        "first_name": "KAITLYN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "34013449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Xenia, OH

Sources for this page

Verify at the official NPI Registry.