Individual provider Active NPI

Tamika Lenea McNeal, NP-C

  • Gerontology Nurse Practitioner
  • Huber Heights, OH
National Provider Identifier
1972061083
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN.CNP.024400 Issued in OH
Practice address
6980 Evergreen Cir
Huber Heights, OH 45424-3986
Phone
(937) 414-8788
NPI assigned
Mar 7, 2019
Last updated
Mar 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN.CNP.024400 OH
Gerontology Nurse Practitioner 363LG0600X APRN.CNP.024400 OH Primary
Primary Care Nurse Practitioner 363LP2300X APRN.CNP.024400 OH

Addresses

Primary practice location

6980 Evergreen Cir
Huber Heights, OH 45424-3986

Mailing address

6980 Evergreen Cir
Huber Heights, OH 45424-3986
Phone (937) 414-8788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190429000969 OH Practitioner - Nurse Practitioner 5496097149 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.024400OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospice of Dayton, Inc. CurrentSince Oct 14, 2024 Accepting new patients
Crossroads Hospice of Dayton LLC CurrentSince Nov 6, 2022 Accepting new patients
Pure Healthcare LLC CurrentSince Oct 14, 2024 Accepting new patients
Wound Care Consultants LLC Adult Health CurrentSince Jan 6, 2025 Accepting new patients

Locations

23250 Chagrin Blvd
Ste 150
Beachwood, OH 44122
Phone (216) 402-0027

23250 Chagrin Blvd
Ste 450
Beachwood, OH 44122
Phone (216) 402-0027

2200 Miami Valley Dr
Dayton, OH 45459
Phone (937) 668-7873

7575 Paragon Rd
Dayton, OH 45459
Phone (937) 256-4490

8069 Washington Village Dr
Dayton, OH 45458
Phone (937) 312-3170

324 Wilmington Ave
Kettering, OH 45420
Phone (937) 256-4490

6789 Ridge Rd
Ste 305
Parma, OH 44129
Phone (440) 491-8334

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1972061083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6980 EVERGREEN CIR",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454243986",
            "telephone_number": "937-414-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6980 EVERGREEN CIR",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454243986",
            "telephone_number": "937-414-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEAL",
        "first_name": "TAMIKA",
        "middle_name": "LENEA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP.024400",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "APRN.CNP.024400",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "APRN.CNP.024400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huber Heights, OH

Sources for this page

Verify at the official NPI Registry.