Active NPI
Chris Atwater
- Developmental Disabilities Clinic/Center
- Dayton, OH
National Provider Identifier
1487250718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Disabilities Clinic/Center
- License
- GCW8541
- Practice address
- 5047 Worchester Dr
Dayton, OH 45431-1137 - Phone
- (614) 749-8748
- NPI assigned
- Dec 10, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Developmental Disabilities Clinic/Center | 261QD1600X | GCW8541 | OH | Primary |
Addresses
Primary practice location
5047 Worchester Dr
Dayton, OH 45431-1137
Mailing address
5047 Worchester Dr
Dayton, OH 45431-1137
Phone (614) 749-8748
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 |
|---|---|---|---|
| GCW8541 | OH | MD | Developmental Disabilities Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608076800000",
"number": "1487250718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5047 WORCHESTER DR",
"city": "DAYTON",
"state": "OH",
"postal_code": "454311137",
"telephone_number": "614-749-8748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5047 WORCHESTER DR",
"city": "DAYTON",
"state": "OH",
"postal_code": "454311137",
"telephone_number": "614-749-8748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATWATER",
"first_name": "CHRIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-10",
"last_updated": "2020-12-16",
"certification_date": "2020-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "261QD1600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Developmental Disabilities",
"state": "OH",
"license": "GCW8541",
"primary": true
}
],
"identifiers": [],
"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 Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.