East Side Day Academy

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

201514800905 Issued in OH

Legal business name

EAST SIDE DAY ACADEMY

Practice address

38 Rossmore Ave
Fort Thomas, KY 41075-2214

Phone

(859) 512-3636

NPI assigned

Jun 9, 2015

Organization subpart

No

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

Authorized official

Name

Rebekah Elliott, BA

Title

Ceo

Phone

(859) 512-3636

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1497136048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 ROSSMORE AVE",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410752214",
            "telephone_number": "859-512-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 ROSSMORE AVE",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410752214",
            "telephone_number": "859-512-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SIDE DAY ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-09",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "REBEKAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "859-512-3636",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "OH",
            "license": "201514800905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Anthony Domet, M.D.
• Kyle Benjamin Dougherty, MD
• Tyler Dowdall, OD
• Taylor Duncan, M.D.
• Trevor Dunn
• Kimberly K Edwards, PA-C
• Carolina Caldera Ehlinger, PH.D
• Michael N Elleman, M.D.
• Andrew Elliott, M.D.
• Daryl Leon Emery, MD

• Developmentally Disabled Services Day Training Agency in Fort Thomas, KY
• Providers in Fort Thomas, KY by specialty
• Developmentally Disabled Services Day Training Agency in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; 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.