NPIMap

Organization Active NPI

Impact Dayton

  • Case Management Agency
  • Dayton, OH
National Provider Identifier
1205666542
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
IMPACT DAYTON
Practice address
5325 Wood Dale Dr
Dayton, OH 45414-3838
Phone
(937) 620-7090
NPI assigned
Aug 2, 2024
Last updated
Aug 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Authorized official

Name
Kanika DixNPI 1245102375
Title
Executive Director
Phone
(937) 620-3918

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary
Developmentally Disabled Services Day Training Agency 251C00000X

Addresses

Primary practice location

5325 Wood Dale Dr
Dayton, OH 45414-3838

Mailing address

5325 Wood Dale Dr
Dayton, OH 45414-3838
Phone (937) 620-7090

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1722556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1205666542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 WOOD DALE DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143838",
            "telephone_number": "937-620-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 WOOD DALE DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143838",
            "telephone_number": "937-620-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT DAYTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-02",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "DIX",
        "authorized_official_first_name": "KANIKA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "937-620-3918"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Aug 6, 2024; 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.