Active NPI
Bethany Ann Ederer, LSW
- Social Worker
- Dayton, OH
National Provider Identifier
1255810040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S1450414
- Practice address
- 2555 S Dixie Dr Ste 260
Dayton, OH 45409-1542 - Phone
- (937) 853-9061
- NPI assigned
- Aug 13, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | S1450414 | OH | Primary |
Addresses
Primary practice location
2555 S Dixie Dr Ste 260
Dayton, OH 45409-1542
Mailing address
897 Shady LN
Beavercreek Township, OH 45434-7140
Phone (937) 269-5212
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S1450414 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574380800000",
"number": "1255810040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "897 SHADY LN",
"city": "BEAVERCREEK TOWNSHIP",
"state": "OH",
"postal_code": "454347140",
"telephone_number": "937-269-5212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2555 S DIXIE DR STE 260",
"city": "DAYTON",
"state": "OH",
"postal_code": "454091542",
"telephone_number": "937-853-9061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDERER",
"first_name": "BETHANY",
"middle_name": "ANN",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-13",
"last_updated": "2019-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S1450414",
"primary": true
}
],
"identifiers": [],
"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 Nov 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.