Individual provider Active NPI

Charles Lamar Daniels

  • Case Manager/Care Coordinator
  • Fairfield, OH
National Provider Identifier
1356914576
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
7416 Polo Springs CT
Fairfield, OH 45014-4780
Phone
(513) 704-1268
NPI assigned
Jul 24, 2021
Last updated
Mar 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

7416 Polo Springs CT
Fairfield, OH 45014-4780

Mailing address

PO Box 40153
Cincinnati, OH 45240-0153
Phone (513) 704-1268

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prosperity Bound LLC Case Manager/Care Coordinator CurrentSince Aug 1, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1627084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1356914576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40153",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452400153",
            "telephone_number": "513-704-1268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7416 POLO SPRINGS CT",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450144780",
            "telephone_number": "513-704-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "CHARLES",
        "middle_name": "LAMAR",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-24",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.