Individual provider Active NPI

Vicki L. Jeffery

  • Driver
  • Dayton, OH
National Provider Identifier
1205636909
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
Practice address
4339 Breezewood Ave
Dayton, OH 45406-1315
Phone
(937) 554-8987
NPI assigned
Mar 13, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X FNU1122 OH
Driver 172A00000X OH
Non-emergency Medical Transport (VAN) 343900000X
Driver 172A00000X Primary

Addresses

Primary practice location

4339 Breezewood Ave
Dayton, OH 45406-1315

Mailing address

4339 Breezewood Ave
Dayton, OH 45406-1315
Phone (937) 554-8987

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
FNU1122OHMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1741824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1205636909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4339 BREEZEWOOD AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454061315",
            "telephone_number": "937-554-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4339 BREEZEWOOD AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454061315",
            "telephone_number": "937-554-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERY",
        "first_name": "VICKI",
        "middle_name": "L.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-13",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "OH",
            "license": "FNU1122",
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "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 Mar 13, 2025; 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.