NPIMap

Organization Active NPI

Fairborn Mental Health LLC

Doing business as Fairborn Mental Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Fairborn, OH
National Provider Identifier
1669978656
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.18073 Issued in OH
Legal business name
FAIRBORN MENTAL HEALTH LLC
Doing business as
Fairborn Mental Health
Practice address
323 N Broad St
Fairborn, OH 45324-4934
Phone
(937) 318-8103
Fax
(937) 867-5268
NPI assigned
Mar 30, 2018
Last updated
Mar 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2018

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

Authorized official

Name
Ms. Sheila R Dunn, APRNNPI 1427428929
Title
Owner
Phone
(937) 768-6867

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X APRN.CNP.18073 OH Primary

Addresses

Primary practice location

323 N Broad St
Fairborn, OH 45324-4934

Mailing address

323 N Broad St
Fairborn, OH 45324-4934
Phone (937) 318-8103

Other names 1

  • Fairborn Mental Health Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522368000000",
    "number": "1669978656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 N BROAD ST",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453244934",
            "telephone_number": "937-318-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 N BROAD ST",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453244934",
            "telephone_number": "937-318-8103",
            "fax_number": "937-867-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBORN MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-30",
        "last_updated": "2018-03-30",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-768-6867",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.18073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairborn Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 30, 2018; 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.