NPIMap

Organization Active NPI

Wings Support and Recovery

  • Community/Behavioral Health Agency
  • Marysville, OH
National Provider Identifier
1669940995
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
WINGS SUPPORT AND RECOVERY
Practice address
729 S Walnut St
Marysville, OH 43040-1643
Phone
(937) 642-9555
NPI assigned
Nov 5, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Authorized official

Name
Mrs. Jullian Griesheimer, MSW, LICDC, LSWNPI 1982110029
Title
Executive Director
Phone
(937) 599-9555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

729 S Walnut St
Marysville, OH 43040-1643

Mailing address

729 S Walnut St
Marysville, OH 43040-1643
Phone (937) 642-9555

Other names 1

  • Wings Support and Recovery Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240219001832 OH Part B Supplier - Clinic/Group Practice 5597109439 Receives reassigned benefits from 4 practitioners
Practice locations: Marysville, OH

National Provider Directory

National Provider Directory
Tax ID family
Wings Enrichment Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/wingsrecoveryohio/r4/

Practitioners & affiliated clinicians

Practitioners 70

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 70

NPI Registry JSON

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1669940995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 S WALNUT ST",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430401643",
            "telephone_number": "937-642-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 S WALNUT ST",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430401643",
            "telephone_number": "937-642-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINGS SUPPORT AND RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-05",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "GRIESHEIMER",
        "authorized_official_first_name": "JULLIAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "937-599-9555",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW, LICDC, LSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wings Support and Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marysville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; 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.