Active NPI
Bruce L Ladle, PHD
- Rehabilitation Psychologist
- Dayton, OH
National Provider Identifier
1205921061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Psychologist
- License
- 4850
- Practice address
- 30 E Apple St
Suite 6255
Dayton, OH 45409-2939 - Phone
- (937) 208-4452
- Fax
- (937) 208-3893
- NPI assigned
- Oct 4, 2006
- Last updated
- Aug 13, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Psychologist | 103TR0400X | 4850 | OH | Primary |
Addresses
Primary practice location
30 E Apple St
Suite 6255
Dayton, OH 45409-2939
Mailing address
30 E Apple St
Suite 6255
Dayton, OH 45409-2939
Phone (937) 208-4452
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0981497 | Medicaid | OH | |
| 5935608 | Medicaid | OH | |
| 31053750400 | Other | ND | BWC PSYCHOLOGIST |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Health Specialists Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Health Psychology Associates
- Clinical Psychologist
- Dayton, OH
- NPI 1235315169
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407888000000",
"number": "1205921061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 E APPLE ST",
"address_2": "SUITE 6255",
"city": "DAYTON",
"state": "OH",
"postal_code": "454092939",
"telephone_number": "937-208-4452",
"fax_number": "937-208-3893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 E APPLE ST",
"address_2": "SUITE 6255",
"city": "DAYTON",
"state": "OH",
"postal_code": "454092939",
"telephone_number": "937-208-4452",
"fax_number": "937-208-3893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LADLE",
"first_name": "BRUCE",
"middle_name": "L",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2014-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": "OH",
"license": "4850",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0981497",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5935608",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BWC PSYCHOLOGIST",
"identifier": "31053750400",
"state": "ND"
}
],
"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 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.