Individual provider Active NPI

Marie R Eakle, RN

  • Infusion Therapy Registered Nurse
  • Kettering, OH
National Provider Identifier
1437332673
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Registered NurseTaxonomy code 163WI0500X
License
120639 Issued in OH
Practice address
928 Rio LN
Kettering, OH 45429-2106
Phone
(937) 271-5953
NPI assigned
Dec 11, 2007
Last updated
Aug 27, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Registered Nurse 163WI0500X 120639 OH Primary

Addresses

Primary practice location

928 Rio LN
Kettering, OH 45429-2106

Mailing address

928 Rio LN
Kettering, OH 45429-4704
Phone (937) 271-5953

Other identifiers 1

IdentifierTypeStateIssuer
3616507MedicaidOH

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
120639OHMDInfusion Therapy Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1437332673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 RIO LN",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454294704",
            "telephone_number": "937-271-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 RIO LN",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454292106",
            "telephone_number": "937-271-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAKLE",
        "first_name": "MARIE",
        "middle_name": "R",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "OH",
            "license": "120639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3616507",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.