Active NPI
Trevar Staches
- Driver
- Dayton, OH
National Provider Identifier
1689408213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- UT844976
- Practice address
- 4816 Harlou Dr
Dayton, OH 45432-1620 - Phone
- (478) 919-4145
- NPI assigned
- Aug 27, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | UT844976 | OH | Primary |
Addresses
Primary practice location
4816 Harlou Dr
Dayton, OH 45432-1620
Mailing address
4816 Harlou Dr
Dayton, OH 45432-1620
Phone (478) 919-4145
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
| License | State | Type | Specialty |
|---|---|---|---|
| UT844976 | OH | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724716800000",
"number": "1689408213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4816 HARLOU DR",
"city": "DAYTON",
"state": "OH",
"postal_code": "454321620",
"telephone_number": "478-919-4145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4816 HARLOU DR",
"city": "DAYTON",
"state": "OH",
"postal_code": "454321620",
"telephone_number": "478-919-4145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STACHES",
"first_name": "TREVAR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-08-27",
"last_updated": "2024-08-27",
"certification_date": "2024-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Driver",
"state": "OH",
"license": "UT844976",
"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 Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.