Individual provider Active NPI

Lynda Bates

  • Psychiatric/Mental Health Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1205686250
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0035925 Issued in OH
Practice address
865 S Patterson Blvd
Dayton, OH 45402-2624
Phone
(937) 966-4673
NPI assigned
Mar 25, 2024
Last updated
Nov 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0035925 OH Primary

Addresses

Primary practice location

865 S Patterson Blvd
Dayton, OH 45402-2624

Mailing address

100 Crowne Point PL
Cincinnati, OH 45241-5427
Phone (513) 743-7628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250213003028 OH Practitioner - Nurse Practitioner 1052841483 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Decoach Team LLC CurrentSince Dec 2, 2024 Accepting new patients
Decoach Team LLC CurrentSince Apr 1, 2021 Accepting new patients

Locations

1620 Harrison Ave
Cincinnati, OH 45214
Phone (513) 892-4673

865 S Patterson Blvd
Dayton, OH 45402
Phone (937) 966-4673

2172 US Route 127 N
Eaton, OH 45320
Phone (937) 456-5811

6570 Sosna Dr
Fairfield, OH 45014
Phone (513) 942-4673

3103 Dixie Hwy
Hamilton, OH 45015
Phone (513) 892-4673

100 Crowne Point Pl
Sharonville, OH 45241
Phone (513) 743-7628

36 N Detroit St
Ste 105
Xenia, OH 45385
Phone (513) 942-4673

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1205686250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROWNE POINT PL",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452415427",
            "telephone_number": "513-743-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 S PATTERSON BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022624",
            "telephone_number": "937-966-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "LYNDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0035925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.