NPIMap

Organization Active NPI

I Am Boundless, Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Fairborn, OH
National Provider Identifier
1104700822
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
I AM BOUNDLESS, INC
Practice address
1460 Graceland Dr
Fairborn, OH 45324-4374
Phone
(614) 844-3800
Fax
(614) 515-5779
NPI assigned
Aug 5, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Authorized official

Name
Laurie B Hickman
Title
Contracting & Credentialing Manager
Phone
(614) 844-3800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

1460 Graceland Dr
Fairborn, OH 45324-4374

Mailing address

445 E Dublin Granville Rd Ste H
Worthington, OH 43085-3192
Phone (614) 844-3800

National Provider Directory

National Provider Directory
Tax ID family
I Am Boundless Inc31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1754352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1104700822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 E DUBLIN GRANVILLE RD STE H",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853192",
            "telephone_number": "614-844-3800",
            "fax_number": "614-844-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 GRACELAND DR",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453244374",
            "telephone_number": "614-844-3800",
            "fax_number": "614-515-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I AM BOUNDLESS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-05",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CONTRACTING & CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "614-844-3800"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairborn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.