Individual provider Active NPI

Antwan John Hairston

  • Homemaker
  • Dayton, OH
National Provider Identifier
1902695562
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
License
TE267711 Issued in OH
Practice address
3677 Karwin Dr
Dayton, OH 45406-3610
Phone
(937) 503-0175
NPI assigned
May 1, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Homemaker 376J00000X TE267711 OH Primary

Addresses

Primary practice location

3677 Karwin Dr
Dayton, OH 45406-3610

Mailing address

3677 Karwin Dr
Dayton, OH 45406-3610
Phone (937) 503-0175

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
TE267711OHMDHomemaker

NPI Registry JSON

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

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1902695562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3677 KARWIN DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454063610",
            "telephone_number": "937-503-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3677 KARWIN DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454063610",
            "telephone_number": "937-503-0175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIRSTON",
        "first_name": "ANTWAN",
        "middle_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "OH",
            "license": "TE267711",
            "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 May 1, 2025; 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.