Individual provider Active NPI

Monique Lauren Wiley

  • Case Manager/Care Coordinator
  • Fairborn, OH
National Provider Identifier
1538876958
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
302 W Main St
Fairborn, OH 45324-5037
Phone
(513) 892-4673
NPI assigned
Nov 4, 2022
Last updated
Dec 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

302 W Main St
Fairborn, OH 45324-5037

Mailing address

100 Crowne Point PL
Cincinnati, OH 45241-5427
Phone (513) 743-7628

Other practice location 1

605 S Patterson Blvd
Dayton, OH 45402-2649
Phone (937) 395-4600

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

Practice roles

OrganizationSpecialtyStatusNew patients
Decoach Team LLC CurrentSince Jul 9, 2023 Accepting new patients
Decoach Team LLC CurrentSince Jul 9, 2023 Accepting new patients

Locations

3103 Dixie Hwy
Hamilton, OH 45015
Phone (513) 892-4673

100 Crowne Point Pl
Sharonville, OH 45241
Phone (513) 743-7628

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1538876958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROWNE POINT PL",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452415427",
            "telephone_number": "513-743-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W MAIN ST",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453245037",
            "telephone_number": "513-892-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "605 S Patterson Blvd",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454022649",
            "country_code": "US",
            "telephone_number": "937-395-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILEY",
        "first_name": "MONIQUE",
        "middle_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-04",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "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 Fairborn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.