Individual provider Active NPI

Ebenezer Akoi Asiedu, APRN

  • Adult Health Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1689145013
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN.CNP.023301 Issued in OH
Practice address
721 Miami Chapel Rd
Dayton, OH 45417-4650
Phone
(937) 281-6900
Fax
(937) 208-8828
NPI assigned
Dec 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN.CNP.023301 OH Primary

Addresses

Primary practice location

721 Miami Chapel Rd
Dayton, OH 45417-4650

Mailing address

725 S Ludlow St
Dayton, OH 45402-2610
Phone (937) 208-2004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191115001751 OH Practitioner - Nurse Practitioner 5193157964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Five Rivers Health CentersGroup PAC ID 9335300904, 45 clinicians

Practice addresses (Care Compare)

2261 Philadelphia Dr
Dayton, OH 45406-1814
Phone (937) 281-6800

721 Miami Chapel Rd
Dayton, OH 45417-4650
Phone (937) 281-6800

Hospital & facility affiliations

  • Fidelity Health Care Home health agency, Moraine, OH, CCN 367160
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Five Rivers Health Centers CurrentSince Sep 18, 2019 Accepting new patients
Five Rivers Health Centers Current Accepting new patients
Five Rivers Health Centers CurrentSince Sep 18, 2019 Accepting new patients

Locations

120 W Apple St
Ste C
Dayton, OH 45402
Phone (937) 496-5613

725 S Ludlow St
Dayton, OH 45402
Phone (937) 208-2004

721 Miami Chapel Rd
Dayton, OH 45417
Phone (937) 281-5970

2261 Philadelphia Dr
Dayton, OH 45406
Phone (937) 281-6800

921 S Edwin C Moses Blvd
Dayton, OH 45417
Phone (937) 461-1376

360 Wilson Dr
Ste 150
Xenia, OH 45385

1659 W 2nd St
Xenia, OH 45385
Phone (937) 281-6800

Organizations & group practices 11

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1544486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1689145013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 S LUDLOW ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022610",
            "telephone_number": "937-208-2004",
            "fax_number": "937-208-8828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 MIAMI CHAPEL RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454174650",
            "telephone_number": "937-281-6900",
            "fax_number": "937-208-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASIEDU",
        "first_name": "EBENEZER",
        "middle_name": "AKOI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-11",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP.023301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.