Active NPI
Ann A Bockrath, DDS
- Dentist
- Waynesville, OH
National Provider Identifier
1154439685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30020084
- Practice address
- 4353 E St RT 73
Waynesville, OH 45068 - Phone
- (513) 897-0248
- Fax
- (513) 897-0249
- NPI assigned
- Aug 25, 2006
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 30020084 | OH | Primary |
Addresses
Primary practice location
4353 E St RT 73
Waynesville, OH 45068
Mailing address
4353 E State Route 73
Ste 110
Waynesville, OH 45068-8814
Phone (513) 897-0248
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160502001824 | OH | Order and Referring Only - Dentist | 9830498542 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30020084 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460505600000",
"number": "1154439685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4353 E STATE ROUTE 73",
"address_2": "STE 110",
"city": "WAYNESVILLE",
"state": "OH",
"postal_code": "450688814",
"telephone_number": "513-897-0248",
"fax_number": "513-897-0249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4353 E ST RT 73",
"city": "WAYNESVILLE",
"state": "OH",
"postal_code": "45068",
"telephone_number": "513-897-0248",
"fax_number": "513-897-0249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOCKRATH",
"first_name": "ANN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-25",
"last_updated": "2016-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30020084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waynesville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.