Individual provider Active NPI

Rebecca Khamis

  • Case Manager/Care Coordinator
  • Moraine, OH
National Provider Identifier
1508466566
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
3095 Kettering Blvd
Moraine, OH 45439-1983
Phone
(937) 293-8300
NPI assigned
Oct 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

3095 Kettering Blvd
Moraine, OH 45439-1983

Mailing address

3095 Kettering Blvd
Moraine, OH 45439-1983

Other practice location 1

660 S Main St
Dayton, OH 45402-2708
Phone (937) 461-4800

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

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1508466566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 KETTERING BLVD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 KETTERING BLVD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391983",
            "telephone_number": "937-293-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "660 S Main St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454022708",
            "country_code": "US",
            "telephone_number": "937-461-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAMIS",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moraine, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.