Individual provider Active NPI

Ashley Nicole Dodge

  • Community/Behavioral Health Agency
  • Toledo, OH
National Provider Identifier
1356990394
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
CDCA.171241 Issued in OH
Practice address
5726 Southwyck Blvd Ste 200
Toledo, OH 43614-1510
Phone
(419) 865-5690
Fax
(419) 865-5691
NPI assigned
Sep 11, 2019
Last updated
Sep 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X CDCA.171241 OH Primary

Addresses

Primary practice location

5726 Southwyck Blvd Ste 200
Toledo, OH 43614-1510

Mailing address

4716 Luann Ave
Toledo, OH 43623-3854
Phone (419) 376-6704

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

LicenseStateTypeSpecialty
CDCA.171241OHMDCommunity/Behavioral Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1356990394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 LUANN AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233854",
            "telephone_number": "419-376-6704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5726 SOUTHWYCK BLVD STE 200",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141510",
            "telephone_number": "419-865-5690",
            "fax_number": "419-865-5691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODGE",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": "CDCA.171241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.

Verify at the official NPI Registry.