Individual provider Active NPI

Jane Benner

  • Clinical Social Worker
  • Dayton, OH
National Provider Identifier
1255752275
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0008607 Issued in OH
Practice address
3821 Little York Rd
Dayton, OH 45414
Phone
(937) 454-0092
Fax
(937) 264-1101
NPI assigned
Dec 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I0008607 OH Primary

Addresses

Primary practice location

3821 Little York Rd
Dayton, OH 45414

Mailing address

3821 Little York Rd
Dayton, OH 45414-2409
Phone (937) 454-0092

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140410000886 OH Practitioner - Clinical Social Worker 6800028648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Cincinnati College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Midwest Behavioral Care, LTDGroup PAC ID 6305806886, 4 clinicians

Practice addresses (Care Compare)

3821 Little York Rd
Dayton, OH 45414-2409
Phone (937) 454-0092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0008607OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Behavioral Care CurrentSince Mar 26, 2014 Accepting new patients
Midwest Behavioral Care, LTD CurrentSince Mar 26, 2014 Accepting new patients
A. Davis, MSW, LLC Clinical Past Accepting new patients
Patricia J. Hayes, Psy.D Associates Past Accepting new patients

Locations

3821 Little York Rd
Dayton, OH 45414
Phone (937) 454-0092

28 E Rahn Rd
Ste 105
Kettering, OH 45429
Phone (937) 434-6840

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1255752275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3821 LITTLE YORK RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454142409",
            "telephone_number": "937-454-0092",
            "fax_number": "937-264-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3821 LITTLE YORK RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45414",
            "telephone_number": "937-454-0092",
            "fax_number": "937-264-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNER",
        "first_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-17",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0008607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.