NPIMap

Individual provider Active NPI

Letetia Ivy

  • Behavior Analyst
  • Dayton, OH
National Provider Identifier
1134799273
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
1404 Gascho Dr
Dayton, OH 45410-3305
Phone
(937) 252-7500
NPI assigned
Jun 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

1404 Gascho Dr
Dayton, OH 45410-3305

Mailing address

11 W Monument Ave FL 7
Dayton, OH 45402-1274
Phone (937) 461-4300

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

Practice roles

OrganizationSpecialtyStatusNew patients
Places, Inc CurrentSince Jul 4, 2021 Accepting new patients
Places Incorporated PastSince Jul 4, 2021 Accepting new patients

Locations

11 W Monument Ave
Fl 7
Dayton, OH 45402
Phone (937) 461-4300

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1134799273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 W MONUMENT AVE FL 7",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454021274",
            "telephone_number": "937-461-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 GASCHO DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454103305",
            "telephone_number": "937-252-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY",
        "first_name": "LETETIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "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 Jun 30, 2021; 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.