NPIMap

Organization Active NPI

Samaritan Behavioral Health, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dayton, OH
National Provider Identifier
1629022330
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
01-0503 Issued in OH
Legal business name
SAMARITAN BEHAVIORAL HEALTH, INC.
Practice address
601 S Edwin C Moses Blvd
4TH Floor, NW Building
Dayton, OH 45417-3424
Phone
(937) 734-8333
Fax
(937) 734-8252
NPI assigned
May 19, 2006
Last updated
Aug 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Authorized official

Name
Tabatha L Masters
Title
Billing
Phone
(937) 734-4334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 01-0503 OH Primary

Addresses

Primary practice location

601 S Edwin C Moses Blvd
4TH Floor, NW Building
Dayton, OH 45417-3424

Mailing address

601 S Edwin C Moses Blvd
Dayton, OH 45417-3424
Phone (937) 734-4334

Other identifiers 1

IdentifierTypeStateIssuer
2433450MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101007000860 OH Part B Supplier - Clinic/Group Practice 0244148625 Receives reassigned benefits from 100 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dayton, OH; Eaton, OH; Troy, OH

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Samaritan Behavioral Health Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • Direct secure messaging: brrickey@direct.sbhidomain.com
  • Direct secure messaging: cathurman@direct.sbhidomain.com
  • Direct secure messaging: clvukin@direct.sbhidomain.com

Practitioners & affiliated clinicians

Practitioners 142

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 142

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1629022330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S EDWIN C MOSES BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-734-4334",
            "fax_number": "937-734-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S EDWIN C MOSES BLVD",
            "address_2": "4TH FLOOR, NW BUILDING",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-734-8333",
            "fax_number": "937-734-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "MASTERS",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "937-734-4334"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "OH",
            "license": "01-0503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2433450",
            "state": "OH"
        }
    ],
    "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 Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.