Individual provider Active NPI

Melissa Erin Dunnagan, PTA

  • Physical Therapy Assistant
  • Cincinnati, OH
National Provider Identifier
1194297184
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA-05570 Issued in OH
Practice address
779 Glendale Milford Rd
Cincinnati, OH 45215-1161
Phone
(513) 771-1779
Fax
(513) 771-1000
NPI assigned
Jan 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA-05570 OH Primary

Addresses

Primary practice location

779 Glendale Milford Rd
Cincinnati, OH 45215-1161

Mailing address

11504 Kenn Rd
Cincinnati, OH 45240-2530
Phone (513) 771-1779

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
PTA-05570OHMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1194297184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11504 KENN RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452402530",
            "telephone_number": "513-771-1779",
            "fax_number": "513-771-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "779 GLENDALE MILFORD RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452151161",
            "telephone_number": "513-771-1779",
            "fax_number": "513-771-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNNAGAN",
        "first_name": "MELISSA",
        "middle_name": "ERIN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-02",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA-05570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; 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.