NPIMap

Organization Active NPI

Oneeighty, Inc.

  • Community/Behavioral Health Agency
  • Wooster, OH
National Provider Identifier
1710244637
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ONEEIGHTY, INC.
Practice address
104 Spink St
Wooster, OH 44691-3652
Phone
(330) 264-8498
Fax
(330) 264-3777
NPI assigned
Apr 17, 2012
Last updated
Feb 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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

Authorized official

Name
Bobbi Douglas
Title
Executive Director
Phone
(330) 264-8498

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

104 Spink St
Wooster, OH 44691-3652

Mailing address

104 Spink St
Wooster, OH 44691-3652
Phone (330) 264-8498

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150916001983 OH Part B Supplier - Clinic/Group Practice 7214244748 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
Practice locations: Wooster, OH; Millersburg, OH

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Oneeighty3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

34 S Clay St
Ste C
Millersburg, OH 44654
Phone (330) 264-8498

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454889600000",
    "number": "1710244637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SPINK ST",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446913652",
            "telephone_number": "330-264-8498",
            "fax_number": "330-264-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 SPINK ST",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446913652",
            "telephone_number": "330-264-8498",
            "fax_number": "330-264-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONEEIGHTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-17",
        "last_updated": "2016-02-08",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "BOBBI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "330-264-8498"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; 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.