Active NPI
Eva Speakman
- Physical Disabilities Residential Treatment Facility
- Leesburg, OH
National Provider Identifier
1962810457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Disabilities Residential Treatment Facility
- License
- 3004386
- Practice address
- 208 E Main St
Leesburg, OH 45135-9660 - Phone
- (937) 780-1081
- NPI assigned
- Jul 28, 2014
- Last updated
- Jul 28, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Disabilities Residential Treatment Facility | 320700000X | 3004386 | OH | Primary |
Addresses
Primary practice location
208 E Main St
Leesburg, OH 45135-9660
Mailing address
208 E Main St
Leesburg, OH 45135-9660
Phone (937) 780-2082
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3004386 | Other | OH | OHIO FAMILY JOB AND SERVICES - MY CARE OHIO |
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 |
|---|---|---|---|
| 3004386 | OH | MD | Physical Disabilities Residential Treatment Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406505600000",
"number": "1962810457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 E MAIN ST",
"city": "LEESBURG",
"state": "OH",
"postal_code": "451359660",
"telephone_number": "937-780-2082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 E MAIN ST",
"city": "LEESBURG",
"state": "OH",
"postal_code": "451359660",
"telephone_number": "937-780-1081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEAKMAN",
"first_name": "EVA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-28",
"last_updated": "2014-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "320700000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Physical Disabilities",
"state": "OH",
"license": "3004386",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO FAMILY JOB AND SERVICES - MY CARE OHIO",
"identifier": "3004386",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leesburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.