NA

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

401253500611 Issued in OH

Legal business name

NA

Practice address

3385 Greenwich Dr
Fairfield, OH 45014-5322

Phone

(513) 939-9789

NPI assigned

Sep 2, 2013

Organization subpart

No

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

Authorized official

Name

Aimee Wynn

Title

Stna

Phone

(513) 939-9789

Specialties & licenses 1

Addresses

Tax ID family

Early Interverntion2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Early Interverntion

  • Early Intervention Provider Agency
  • Long Beach, NY
  • NPI 1063667111
  NPD tax ID

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

{
    "created_epoch": "1378080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378080000000",
    "number": "1235563701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3385 GREENWICH DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145322",
            "telephone_number": "513-939-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3385 GREENWICH DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145322",
            "telephone_number": "513-939-9789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-02",
        "last_updated": "2013-09-02",
        "status": "A",
        "authorized_official_last_name": "WYNN",
        "authorized_official_first_name": "AIMEE",
        "authorized_official_title_or_position": "STNA",
        "authorized_official_telephone_number": "513-939-9789"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OH",
            "license": "401253500611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karrie Mushaben, RN
• Nicole Muskopf, PHARMD
• Lynne Mutuku
• Myeyedr Optometry of Ohio, LLC
• Myeyedr Optometry of Ohio, LLC
• Jennifer Nabel, LISW
• Aiswarya Nagappan, MD
• Girish Babu Nagesetty, MD
• Namsu Service Care LLC
• Kulumani M Narasimhan, MD

• Nursing Facility/Intermediate Care Facility in Fairfield, OH
• Providers in Fairfield, OH by specialty
• Nursing Facility/Intermediate Care Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2013; 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.