Individual provider Active NPI

Aeisha Massengale, LPN

  • Licensed Practical Nurse
  • Trotwood, OH
National Provider Identifier
1124313002
Registry record updated Jun 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN112441 Issued in OH
Practice address
5257 Wood Creek Rd
Trotwood, OH 45426-1615
Phone
(937) 422-7445
NPI assigned
Jun 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN112441 OH Primary

Addresses

Primary practice location

5257 Wood Creek Rd
Trotwood, OH 45426-1615

Mailing address

5257 Wood Creek Rd
Trotwood, OH 45426-1615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN112441OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1308355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308355200000",
    "number": "1124313002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5257 WOOD CREEK RD",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "454261615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5257 WOOD CREEK RD",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "454261615",
            "telephone_number": "937-422-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSENGALE",
        "first_name": "AEISHA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-18",
        "last_updated": "2011-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN112441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trotwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2011; 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.