Active NPI
Deena Meddock
- Pharmacy Technician
- Kettering, OH
National Provider Identifier
1467178426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 09307313
- Practice address
- 1827 Woodman Center Dr
Kettering, OH 45420-1157 - Phone
- (937) 558-3408
- NPI assigned
- Oct 12, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.180033 | OH | |
| Pharmacy Technician | 183700000X | 09307313 | OH | Primary |
Addresses
Primary practice location
1827 Woodman Center Dr
Kettering, OH 45420-1157
Mailing address
1827 Woodman Center Dr
Kettering, OH 45420-1157
Phone (937) 558-3408
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 |
|---|---|---|---|
| CDCA.180033 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| 09307313 | OH | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665532800000",
"number": "1467178426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1827 WOODMAN CENTER DR",
"city": "KETTERING",
"state": "OH",
"postal_code": "454201157",
"telephone_number": "937-558-3408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1827 WOODMAN CENTER DR",
"city": "KETTERING",
"state": "OH",
"postal_code": "454201157",
"telephone_number": "937-558-3408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDDOCK",
"first_name": "DEENA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-12",
"last_updated": "2022-10-12",
"certification_date": "2022-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.180033",
"primary": false
},
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "OH",
"license": "09307313",
"primary": true
}
],
"identifiers": [],
"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 Oct 12, 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.