Organization Active NPI

Independent Provider

  • Respite Care
  • Arcanum, OH
National Provider Identifier
1992910863
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
Legal business name
INDEPENDENT PROVIDER
Practice address
308 W 1St St
Arcanum, OH 45304-1167
Phone
(937) 692-8081
NPI assigned
May 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
David Martin FergusonNPI 1255760559
Title
Independent
Phone
(937) 692-8081

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X NU Primary

Addresses

Primary practice location

308 W 1St St
Arcanum, OH 45304-1167

Mailing address

308 W 1St St
Arcanum, OH 45304-1167

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992910863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 W 1ST ST",
            "city": "ARCANUM",
            "state": "OH",
            "postal_code": "453041167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 W 1ST ST",
            "city": "ARCANUM",
            "state": "OH",
            "postal_code": "453041167",
            "telephone_number": "937-692-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT PROVIDER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "INDEPENDENT",
        "authorized_official_telephone_number": "937-692-8081"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcanum, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.