Organization Active NPI

Neuropsychology Services of Southwest Ohio, LLC

  • Clinical Neuropsychologist
  • Dayton, OH
National Provider Identifier
1083043079
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
6061 Issued in OH
Legal business name
NEUROPSYCHOLOGY SERVICES OF SOUTHWEST OHIO, LLC
Practice address
1 Elizabeth PL
Dayton, OH 45417-3445
Phone
(937) 424-8306
Fax
(937) 222-7726
NPI assigned
Nov 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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

Authorized official

Name
Dr. Nicholas Doninger, PHD
Title
Owner
Phone
(847) 421-6323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X 6061 OH Primary

Addresses

Primary practice location

1 Elizabeth PL
Dayton, OH 45417-3445

Mailing address

4954 Walnut Walk
Kettering, OH 45429-1936
Phone (847) 421-6323

Other identifiers 1

IdentifierTypeStateIssuer
0094672MedicaidOH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391558400000",
    "number": "1083043079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4954 WALNUT WALK",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291936",
            "telephone_number": "847-421-6323",
            "fax_number": "937-395-8139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELIZABETH PL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173445",
            "telephone_number": "937-424-8306",
            "fax_number": "937-222-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROPSYCHOLOGY SERVICES OF SOUTHWEST OHIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-11",
        "last_updated": "2014-02-05",
        "status": "A",
        "authorized_official_last_name": "DONINGER",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-421-6323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "OH",
            "license": "6061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094672",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.