Pathways Provider LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

PATHWAYS PROVIDER LLC

Practice address

1921 Kipling Dr
Dayton, OH 45406-3821

Phone

(937) 654-8775

NPI assigned

Oct 4, 2022

Organization subpart

No

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

Authorized official

Name

Kristin Draper

Title

Owner/Doo

Phone

(937) 654-8775

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664841600000",
    "number": "1760106678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 KIPLING DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454063821",
            "telephone_number": "937-654-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 KIPLING DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454063821",
            "telephone_number": "937-654-8775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAYS PROVIDER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A",
        "authorized_official_last_name": "DRAPER",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "OWNER/DOO",
        "authorized_official_telephone_number": "937-654-8775"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "pathwaysprovider@gmail.com",
            "affiliation": "N",
            "address_1": "1921 Kipling Dr",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454063821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.