Kacie Whaley
Individual provider Active NPI Child Intellectual and/or Developmental Disabilities Respite Care · West Alexandria, OH
NPI 1366045353 · NPPES record last updated Nov 20, 2020
Key facts
- NPI
- 1366045353
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X
- License
- 6800484 (OH)
- Practice address
- 2161 Jordan Rd
West Alexandria, OH 45381-9713 - Phone
- (937) 533-1354
- NPI assigned
- Nov 20, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6800484 | OH | MD | Child Intellectual and/or Developmental Disabilities Respite Care |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X | 6800484 | OH | Yes |
Addresses
Primary practice location
2161 Jordan Rd
West Alexandria, OH 45381-9713
Mailing address
2161 Jordan Rd
West Alexandria, OH 45381-9713
Phone (937) 533-1354
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6800484 | Medicaid | OH |
Other providers in West Alexandria, OH
- Sheila Stanifer
- Halyna Surhaieva
- Twin Valley Community Local School District
- Twin Valley Family Practice
- Village of West Alexandria
All providers in West Alexandria, OH · Child Intellectual and/or Developmental Disabilities Respite Care in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.