Individual provider Active NPI

Patricia Wright Douglas, LPN

  • Licensed Practical Nurse
  • Dayton, OH
National Provider Identifier
1659507044
Registry record updated May 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN 072392 Issued in OH
Practice address
44 E Bruce Ave
Dayton, OH 45405-2601
Phone
(678) 471-8055
Fax
(937) 723-8217
NPI assigned
May 31, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN 072392 OH Primary

Addresses

Primary practice location

44 E Bruce Ave
Dayton, OH 45405-2601

Mailing address

44 E Bruce Ave
Dayton, OH 45405-2601
Phone (678) 471-8055

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
PN 072392OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1243728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243728000000",
    "number": "1659507044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 E BRUCE AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454052601",
            "telephone_number": "678-471-8055",
            "fax_number": "937-723-8217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 E BRUCE AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454052601",
            "telephone_number": "678-471-8055",
            "fax_number": "937-723-8217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "PATRICIA",
        "middle_name": "WRIGHT",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-31",
        "last_updated": "2009-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN 072392",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 31, 2009; 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.