Enlightened Therapy Associates, Inc.

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

Legal business name

ENLIGHTENED THERAPY ASSOCIATES, INC.

Practice address

2510 Commons Blvd
Suite 240
Beavercreek, OH 45431-3809

Phone

(937) 429-8620

Fax

(937) 429-8629

NPI assigned

Feb 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Judith Ann O'Connell, D.O.NPI 1306810635

Title

President

Phone

(937) 278-1779

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Judith Ann O'Connell, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Beavercreek, OH
  • NPI 1306810635
  NPD (past) Authorized official

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871632182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 E WOODBURY DR",
            "address_2": "SUITE 106",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454152855",
            "telephone_number": "937-278-1779",
            "fax_number": "937-278-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 COMMONS BLVD",
            "address_2": "SUITE 240",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313809",
            "telephone_number": "937-429-8620",
            "fax_number": "937-429-8629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENLIGHTENED THERAPY ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "O'CONNELL",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-278-1779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.