NPIMap

Organization Active NPI

Susan K Kahle PHD LLC

  • Clinical Psychologist
  • Dayton, OH
National Provider Identifier
1689979353
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5806 Issued in OH
Legal business name
SUSAN K KAHLE PHD LLC
Practice address
2600 Far Hills Ave
Suite 321
Dayton, OH 45419-1687
Phone
(937) 901-3122
Fax
(937) 294-1470
NPI assigned
Jan 11, 2011
Last updated
Jan 11, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Authorized official

Name
Dr. Susan K Kahle, PHDNPI 1366558645
Title
Provider/ Sole Member
Phone
(937) 901-3122

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 5806 OH Primary

Addresses

Primary practice location

2600 Far Hills Ave
Suite 321
Dayton, OH 45419-1687

Mailing address

2600 Far Hills Ave
Suite 321
Dayton, OH 45419-1687
Phone (937) 901-3122

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110215000005 OH Part B Supplier - Clinic/Group Practice 3173703733 Receives reassigned benefits from 1 practitioner
Practice locations: Springboro, OH

National Provider Directory

National Provider Directory

Locations

2600 Far Hills Ave
#321
Oakwood, OH 45419
Phone (937) 294-6794

2600 Far Hills Ave
Ste 321
Oakwood, OH 45419
Phone (614) 792-0018

Practitioners & affiliated clinicians

Practitioners 4

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": "1294704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1689979353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 FAR HILLS AVE",
            "address_2": "SUITE 321",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454191687",
            "telephone_number": "937-901-3122",
            "fax_number": "937-294-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 FAR HILLS AVE",
            "address_2": "SUITE 321",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454191687",
            "telephone_number": "937-901-3122",
            "fax_number": "937-294-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN K KAHLE PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-11",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "KAHLE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PROVIDER/ SOLE MEMBER",
        "authorized_official_telephone_number": "937-901-3122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "5806",
            "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 Jan 11, 2011; 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.