NPIMap

Organization Active NPI

Samaritan Behavioral Health, Inc.

  • Clinic/Center
  • Dayton, OH
National Provider Identifier
1205888641
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
503, 11127 Issued in OH
Legal business name
SAMARITAN BEHAVIORAL HEALTH, INC.
Practice address
601 S Edwin C Moses Blvd
First Floor, NW Building
Dayton, OH 45417-3424
Phone
(937) 224-1694
Fax
(937) 224-1625
NPI assigned
May 16, 2006
Last updated
Aug 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Authorized official

Name
Tabatha L Masters
Title
Billing
Phone
(937) 734-4334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 503, 11127 OH Primary

Addresses

Primary practice location

601 S Edwin C Moses Blvd
First Floor, NW Building
Dayton, OH 45417-3424

Mailing address

601 S Edwin C Moses Blvd
Dayton, OH 45417-3424
Phone (937) 734-4334

Other identifiers 1

IdentifierTypeStateIssuer
2876697MedicaidOH

Other names 1

  • Samaritan CrisisCare Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101007000860 OH Part B Supplier - Clinic/Group Practice 0244148625 Receives reassigned benefits from 100 practitioners
3 other NPIs on this enrollment
Practice locations: Dayton, OH; Eaton, OH; Troy, OH

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/sbhihelp/r4/

Practitioners & affiliated clinicians

Practitioners 127

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.

View all 127

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1205888641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S EDWIN C MOSES BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-734-4334",
            "fax_number": "937-734-8269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S EDWIN C MOSES BLVD",
            "address_2": "FIRST FLOOR, NW BUILDING",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-224-1694",
            "fax_number": "937-224-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "MASTERS",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "937-734-4334"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OH",
            "license": "503, 11127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2876697",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan CrisisCare",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Samaritan CrisisCare",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.