Access Ohio, LLC
Organization Active NPI Substance Abuse Rehabilitation Facility · Dayton, OH
NPI 1194179150 · NPPES record last updated Jul 20, 2023
Key facts
- NPI
- 1194179150
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- License
- 13908 (OH)
- Legal business name
- ACCESS OHIO, LLC
- Practice address
- 2611 Wayne Ave BLDG 64
Dayton, OH 45420-1833 - Phone
- (614) 256-7811
- NPI assigned
- Apr 15, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. John Johnson
- Title
- Ceo
- Phone
- (937) 228-0579
Other NPIs on the same Medicare enrollment 1
Practitioners 82
-
Carl George Arlotta, EDD LPCC
-
Frederick Arrow, LPC
-
Chaitanya Bukkapatnam, MD, MBA
-
Yvonne Y. Clark, CNP
-
Henrik Close IV, MD
-
Misty Lynn Coleman, MSW,LISW-S
-
Gabrielle Delarose, CNP
-
Lynsey Diersing, RN
-
Jacey M Duffy, PMHNP-BC
-
Michelle Fridman, LISW, LICDC
-
Tarsicio Gacheru, CNP
-
Julie Gentile, MD
-
Chandre Gowda, MD
-
Kirsten M Hanson, LISW
-
Bethany Leigh Harper, M.D.
-
Kari Harper, M.D.
-
Kurt Heintzelman, M.D.
-
Jonathan Hester, MD
-
David Huffman, PMHNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D2103924 | Access Ohio LLC | Certificate of waiver | Apr 14, 2028 |
| 36D2234509 | Access Ohio LLC | Certificate of waiver | Apr 20, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130612000051 | OH | Part B Supplier - Clinic/Group Practice | 4385899053 |
Receives reassigned benefits from 66 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Columbus, OH; Mount Gilead, OH; Martins Ferry, OH; London, OH; Delaware, OH; Dayton, OH |
National Provider Directory
Locations
99 N Brice Rd
Ste 360
Columbus, OH 43213
Phone (614) 367-7700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 13909 | OH | |
| Substance Abuse Rehabilitation Facility | 324500000X | 13908 | OH | Yes |
Addresses
Primary practice location
2611 Wayne Ave BLDG 64
Dayton, OH 45420-1833
Mailing address
6400 E Broad St Ste 400
Columbus, OH 43213-2979
Phone (614) 655-3345
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2892919 | Medicaid | OH | |
| 0166703 | Medicaid | OH |
Other names
- Access Ohio
Other providers in Dayton, OH
- Access Home Care, LLC.
- Access Hospital
- Access Hospital Dayton Lab LLC
- Access Hospital Dayton LLC
- Access Ohio LLC
- Access RX Pharmacy LLC
- Access Skilled Care, LLC
- Access Transport, LLC
- Access Transport, LLC
- Access Transport, LLC
All providers in Dayton, OH · Substance Abuse Rehabilitation Facility in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.