Individual provider Active NPI

Tanika Sharee Spidell, D.O.

  • Psychiatry Physician
  • Dayton, OH
National Provider Identifier
1487896478
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
34.016749 Issued in OH
Practice address
1863 Kipling Dr
Dayton, OH 45406-3917
Phone
(703) 382-7871
NPI assigned
Apr 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0102206894 VA
Psychiatry Physician 2084P0800X 34.016749 OH Primary

Addresses

Primary practice location

1863 Kipling Dr
Dayton, OH 45406-3917

Mailing address

1863 Kipling Dr
Dayton, OH 45406-3917

Other names 1

  • Prof. Spidell Consulting Solutions LLC Other name

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
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34.016749OHMDPsychiatry Physician
0102206894VAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1487896478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1863 KIPLING DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454063917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1863 KIPLING DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454063917",
            "telephone_number": "703-382-7871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIDELL",
        "first_name": "TANIKA",
        "middle_name": "SHAREE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-06",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0102206894",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "34.016749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SPIDELL",
            "last_name": "LLC",
            "middle_name": "CONSULTING SOLUTIONS",
            "prefix": "PROF.",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 2, 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.

Verify at the official NPI Registry.