Robert D Quakenbush

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Practice address

4049 Dayton Xenia Rd
Beavercreek, OH 45432-1992

Phone

(937) 429-8500

Fax

(937) 429-8500

NPI assigned

Mar 3, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Esthetic Design

  • Prosthetic/Orthotic Supplier
  • Beavercreek, OH
  • NPI 1184002594
  Authorized official Same address or phone

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1336319664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4049 DAYTON XENIA RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454321992",
            "telephone_number": "937-429-8500",
            "fax_number": "937-429-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4049 DAYTON XENIA RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454321992",
            "telephone_number": "937-429-8500",
            "fax_number": "937-429-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAKENBUSH",
        "first_name": "ROBERT",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0861787",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000000258",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Scott Pritt, P.T.
• Audrey Przyzycki
• Corielle Putnam, LMHC, LPCC
• Emily Pyles
• Pyramid Physician Services LLC
• Brett Quine, CRNA
• Adam Kenton Quinn, MD
• Wendy Rachman, LAC
• Melanie C Raffoul, MD
• Amie Marie Raines, RN

• Prosthetic/Orthotic Supplier in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Prosthetic/Orthotic Supplier in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.