Active NPI
Autumn Monnig
- Social Worker
- Dayton, OH
National Provider Identifier
1467026062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 2208039
- Practice address
- 2611 Wayne Ave BLDG 61
Dayton, OH 45420-1833 - Phone
- (937) 228-0579
- NPI assigned
- May 18, 2021
- Last updated
- Feb 20, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 2208039 | OH | Primary |
Addresses
Primary practice location
2611 Wayne Ave BLDG 61
Dayton, OH 45420-1833
Mailing address
2611 Wayne Ave BLDG 61
Dayton, OH 45420-1833
Other practice location 1
2611 Wayne Ave Bldg 61
Dayton, OH 45420-1833
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2910854 | 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 |
|---|---|---|---|
| 2208039 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoenix Group Home, LLC | Past | Accepting new patients | |
| Phoenix Group Home, LLC | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/pathihc/r4/
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba PATH Integrated Healthcare
- Community/Behavioral Health Agency
- Portsmouth, OH
- NPI 1083146013
-
dba Path Behavioral Health- SUD
- Substance Abuse Rehabilitation Facility
- Cincinnati, OH
- NPI 1336654854
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708387200000",
"number": "1467026062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2611 WAYNE AVE BLDG 61",
"city": "DAYTON",
"state": "OH",
"postal_code": "454201833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2611 WAYNE AVE BLDG 61",
"city": "DAYTON",
"state": "OH",
"postal_code": "454201833",
"telephone_number": "937-228-0579"
}
],
"practiceLocations": [
{
"address_1": "2611 Wayne Ave Bldg 61",
"address_purpose": "LOCATION",
"city": "Dayton",
"state": "OH",
"postal_code": "454201833",
"country_code": "US",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MONNIG",
"first_name": "AUTUMN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-18",
"last_updated": "2024-02-20",
"certification_date": "2024-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "2208039",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2910854",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.