Active NPI
Casey Lakes
- Registered Nurse
- Dayton, OH
National Provider Identifier
1790431377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 406040
- Practice address
- 1 Elizabeth PL
Dayton, OH 45417-3445 - Phone
- (937) 813-1737
- NPI assigned
- Feb 23, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 406040 | OH | Primary |
Addresses
Primary practice location
1 Elizabeth PL
Dayton, OH 45417-3445
Mailing address
4569 Cemetery Rd
Saint Paris, OH 43072-9323
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 |
|---|---|---|---|
| 406040 | OH | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645574400000",
"number": "1790431377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4569 CEMETERY RD",
"city": "SAINT PARIS",
"state": "OH",
"postal_code": "430729323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 ELIZABETH PL",
"city": "DAYTON",
"state": "OH",
"postal_code": "454173445",
"telephone_number": "937-813-1737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKES",
"first_name": "CASEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-23",
"last_updated": "2022-02-23",
"certification_date": "2022-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "406040",
"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 Feb 23, 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.