Individual provider Active NPI

Leonor N. Aguilar, N.P.

  • Family Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1265583785
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15269 Issued in OH
Practice address
5981 Far Hills Ave
Dayton, OH 45429-2211
Phone
(937) 428-6702
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA15269NP OH
Nurse Practitioner 363L00000X N.P. 15826 CA
Family Nurse Practitioner 363LF0000X 15269 OH Primary

Addresses

Primary practice location

5981 Far Hills Ave
Dayton, OH 45429-2211

Mailing address

5981 Far Hills Ave
Dayton, OH 45429-2211
Phone (323) 428-4240

Other practice location 1

1989 Miamisburg Centerville Rd Ste 201
Centerville, OH 45459-3858
Phone (937) 401-7575

Other identifiers 2

IdentifierTypeStateIssuer
1265583785MedicaidCA
0102999MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address laguilar530389@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140618000369 OH Practitioner - Nurse Practitioner 9739330465 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
15269OHMDOrthodontics and Dentofacial Orthopedic Dentist
N.P. 15826CAMDNurse Practitioner
COA15269NPOHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc CurrentSince Dec 29, 2022 Accepting new patients
County of Los Angeles PastSince Sep 18, 2012 Accepting new patients

Locations

1989 Miamisburg Centerville Rd
Ste 201
Dayton, OH 45459
Phone (937) 401-7575

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

Organizations & group practices 2

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1265583785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5981 FAR HILLS AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292211",
            "telephone_number": "323-428-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5981 FAR HILLS AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292211",
            "telephone_number": "937-428-6702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1989 Miamisburg Centerville Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454593858",
            "country_code": "US",
            "telephone_number": "937-401-7575",
            "fax_number": "937-522-8350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGUILAR",
        "first_name": "LEONOR",
        "middle_name": "N.",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA15269NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "N.P. 15826",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "15269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265583785",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0102999",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "laguilar530389@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "1989 Miamisburg Centerville Rd Ste 201",
            "city": "Centerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454593858",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1989 Miamisburg Centerville Rd Ste 201",
            "city": "Centerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454593858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.