Maple Tree Cancer Alliance

Primary specialty

Clinical Exercise PhysiologistTaxonomy code 224Y00000X

Legal business name

MAPLE TREE CANCER ALLIANCE

Practice address

3535 Pentagon Blvd
Beavercreek, OH 45431-1705

Phone

(937) 477-8213

NPI assigned

Jun 20, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Karen Y Wonders, PH.D.

Title

Executive Director

Phone

(937) 477-8213

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523232000000",
    "number": "1992225148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N FINDLAY ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454042203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 PENTAGON BLVD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454311705",
            "telephone_number": "937-477-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE TREE CANCER ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-20",
        "last_updated": "2018-04-09",
        "status": "A",
        "authorized_official_last_name": "WONDERS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "937-477-8213",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Exercise Physiologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Mann, LCSW
• Karie L. Mann, LISW
• Rahul Manne
• Valerie Mantz
• Leanna Elaine Manuel, PSY.D.
• Kaitlyn Elizabeth Marker
• Gabrielle Markley
• Nicole Joanne Martinez
• Amy Mason, OT
• Timothy Mason, OD

• Clinical Exercise Physiologist in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Clinical Exercise Physiologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; 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.