Active NPI
Mindy Davis
- Skilled Nursing Facility
- Wilmington, OH
National Provider Identifier
1982094587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- PTA08438
- Practice address
- 75 Hale St
Wilmington, OH 45177-2104 - Phone
- (937) 382-1621
- NPI assigned
- Feb 3, 2015
- 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 |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | PTA08438 | OH | Primary |
Addresses
Primary practice location
75 Hale St
Wilmington, OH 45177-2104
Mailing address
942 Balsam Wood LN
Lebanon, OH 45036-8528
Phone (937) 763-5585
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PTA08438 | Other | OH | OTPTAT |
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 |
|---|---|---|---|
| PTA08438 | OH | MD | Skilled Nursing Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709856000000",
"number": "1982094587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "942 BALSAM WOOD LN",
"city": "LEBANON",
"state": "OH",
"postal_code": "450368528",
"telephone_number": "937-763-5585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 HALE ST",
"city": "WILMINGTON",
"state": "OH",
"postal_code": "451772104",
"telephone_number": "937-382-1621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MINDY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-03",
"last_updated": "2024-03-08",
"certification_date": "2024-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "OH",
"license": "PTA08438",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTPTAT",
"identifier": "PTA08438",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.