Individual provider Active NPI

Michelle New

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Middletown, OH
National Provider Identifier
1831602192
Registry record updated Nov 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
0245289 Issued in OH
Practice address
6374 Elk Creek Rd
Middletown, OH 45042-8921
Phone
(513) 504-6979
NPI assigned
Nov 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 0245289 OH Primary

Addresses

Primary practice location

6374 Elk Creek Rd
Middletown, OH 45042-8921

Mailing address

917 Hartz Dr
Lebanon, OH 45036-1325
Phone (513) 504-6979

Other identifiers 2

IdentifierTypeStateIssuer
0245289MedicaidOH
8304801OtherOHDODD CONTRACT #

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

LicenseStateTypeSpecialty
0245289OHMDIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

NPI Registry JSON

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510099200000",
    "number": "1831602192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 HARTZ DR",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450361325",
            "telephone_number": "513-504-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6374 ELK CREEK RD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450428921",
            "telephone_number": "513-504-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEW",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2017-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OH",
            "license": "0245289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0245289",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DODD CONTRACT #",
            "identifier": "8304801",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2017; 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.