Individual provider Active NPI

Dotralee McNeal, CBHCM

  • Case Manager/Care Coordinator
  • Titusville, FL
National Provider Identifier
1639734767
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
CBHCM102301 Issued in FL
Practice address
835 Sycamore St # H8
Titusville, FL 32780-7700
Phone
(352) 431-6337
NPI assigned
May 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X CBHCM102301 FL Primary

Addresses

Primary practice location

835 Sycamore St # H8
Titusville, FL 32780-7700

Mailing address

1021 S Park Ave Apt 901
Titusville, FL 32780-3958
Phone (352) 431-6337

Other identifiers 1

IdentifierTypeStateIssuer
CBHCM102301MedicaidFL

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

State licenses

LicenseStateTypeSpecialty
CBHCM102301FLMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Productive Pathways Transitional Services, Inc Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1639734767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 S PARK AVE APT 901",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327803958",
            "telephone_number": "352-431-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 SYCAMORE ST # H8",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327807700",
            "telephone_number": "352-431-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEAL",
        "first_name": "DOTRALEE",
        "credential": "CBHCM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-03",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "CBHCM102301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CBHCM102301",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.