Individual provider Active NPI

Amanda Reimer

  • Clinical Social Worker
  • Dayton, OH
National Provider Identifier
1386148179
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2203739-SUPV Issued in OH
Practice address
601 South Edwin C Moses Blvd
Dayton, OH 45417-3424
Phone
(937) 734-8333
NPI assigned
Mar 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1900942-TRNE OH
Social Worker 104100000X S.2004881 OH
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X I.2203739-SUPV OH Primary

Addresses

Primary practice location

601 South Edwin C Moses Blvd
Dayton, OH 45417-3424

Mailing address

601 South Edwin C Moses Blvd
Dayton, OH 45417-3424
Phone (937) 734-8333

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230609000117 OH Practitioner - Clinical Social Worker 1658738406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J Kilby Enterprises IncGroup PAC ID 7214302223, 8 clinicians

Practice addresses (Care Compare)

955 Congress Park Dr
Centerville, OH 45459-4009
Phone (937) 741-8708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1900942-TRNEOHMDSocial Worker
S.2004881OHMDSocial Worker
I.2203739-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
J. Kilby Enterprises, Inc. CurrentSince Apr 1, 2026 Accepting new patients

Locations

955 Congress Park Dr
Dayton, OH 45459
Phone (937) 741-8708

550 N Main St
Unit A
Springboro, OH 45066
Phone (937) 741-8708

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1386148179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SOUTH EDWIN C MOSES BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-734-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SOUTH EDWIN C MOSES BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-734-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIMER",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1900942-TRNE",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2004881",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2203739-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.