Active NPI
Theresa Mhanna, DAOM, OM, LAC
- Acupuncturist
- Middletown, OH
National Provider Identifier
1396179966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 66.000032
- Practice address
- 3907 Grand Ave
Middletown, OH 45044-6123 - Phone
- (513) 329-5793
- NPI assigned
- Aug 30, 2013
- Last updated
- Jan 6, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 65.000239 | OH | |
| Acupuncturist | 171100000X | |||
| Acupuncturist | 171100000X | 66.000032 | OH | Primary |
Addresses
Primary practice location
3907 Grand Ave
Middletown, OH 45044-6123
Mailing address
3907 Grand Ave
Middletown, OH 45044-6123
Phone (513) 329-5793
Other practice location 1
139 N. St. Rt. 42 Waynesville, OH 45068
Waynesville,, OH 45468
Phone (513) 320-0029
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 460585977-00 | Other | OH | BWC |
| 1396179966 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 65.000239 | OH | MD | Acupuncturist |
| 66.000032 | OH | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641427200000",
"number": "1396179966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3907 GRAND AVE",
"city": "MIDDLETOWN",
"state": "OH",
"postal_code": "450446123",
"telephone_number": "513-329-5793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3907 GRAND AVE",
"city": "MIDDLETOWN",
"state": "OH",
"postal_code": "450446123",
"telephone_number": "513-329-5793"
}
],
"practiceLocations": [
{
"address_1": "139 N. St. Rt. 42 Waynesville, OH 45068",
"address_purpose": "LOCATION",
"city": "Waynesville,",
"state": "OH",
"postal_code": "45468",
"country_code": "US",
"telephone_number": "513-320-0029",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MHANNA",
"first_name": "THERESA",
"name_prefix": "Dr.",
"credential": "DAOM, OM, LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-30",
"last_updated": "2022-01-06",
"certification_date": "2022-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "OH",
"license": "65.000239",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": null,
"license": null,
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "OH",
"license": "66.000032",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BWC",
"identifier": "460585977-00",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1396179966",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Middletown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.