Active NPI
Domonique Burch
- Case Manager/Care Coordinator
- Dayton, OH
National Provider Identifier
1124766928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 1628 Springfield St
Dayton, OH 45403-1430 - Phone
- (937) 802-5440
- NPI assigned
- May 23, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
1628 Springfield St
Dayton, OH 45403-1430
Mailing address
240 S Heincke Rd Unit 736
Miamisburg, OH 45343-5032
Phone (740) 338-2940
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666310400000",
"number": "1124766928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 S HEINCKE RD UNIT 736",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453435032",
"telephone_number": "740-338-2940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1628 SPRINGFIELD ST",
"city": "DAYTON",
"state": "OH",
"postal_code": "454031430",
"telephone_number": "937-802-5440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURCH",
"first_name": "DOMONIQUE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-23",
"last_updated": "2022-10-21",
"certification_date": "2022-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Oct 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.