SOBER NATION LLC (NPI# 1164971073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164971073 |
| Entity Type | Organization |
| Organization Name | SOBER NATION LLC |
| Practice Address |
226 Wonderly Ave Oakwood OH 45419-1755 |
| Practice Telephone | 9379992561 |
| Practice Fax Number | 9372218242 |
| Mailing Telephone | 9379992561 |
| Mailing Fax Number | 9372218242 |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2016-10-04 |
| Authorized Official Name | DR. CHARLES M MISJA (MEDICAL DOCTOR/ OWNER) |
| Authorized Official Telephone | 9372603156 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
FM1575692 | OH | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0051749 | 05 | |
| OH | 0117002 | 05 |
| Street Address |
226 WONDERLY AVE |
| City | OAKWOOD |
| State | OH |
| Zip Code | 45419-1755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962812883 | Velma Barber | Social Worker | 1032 Hampshire Rd, Dayton, OH 45419 | 2014-04-30 |
| 1467894790 | James F. Sheridan | Neurological Surgery | 235 Park Rd, Dayton, OH 45419 | 2013-07-29 |
| 1437365939 | Stacy Marie Purvis | Home Health Aide | 1228 Hale Avenue, Kettering, OH 45419 | 2007-05-14 |
| 1124249727 | Emily Kay Werlein | Counselor | 2600 Far Hills Ave., Suite 304, Dayton, OH 45419 | 2007-05-01 |
| 1568558021 | Dayton Va Medical Center | General Acute Care Hospital | 1730 Ridgeway Rd, Dayton, OH 45419 | 2006-10-04 |
| 1942259742 | David F Vanderburgh | Radiology | 1908 Coolidge Drive, Dayton, OH 45419 | 2006-05-09 |
| 1578552287 | Michael Ian Feldman | Dermatology | 30 Ashridge Rd., Dayton, OH 45419 | 2005-10-14 |
| 1962850222 | Kevin Schmidt Tanager | Pathology | 88 Mdg/sghj, 4881 Sugar Maple Dr, Wright-patterson Afb, OH 45419 | 2016-05-27 |
| 1366558645 | Susan K Kahle | Psychologist | 2600 Far Hills Ave, Suite 321, Oakwood, OH 45419 | 2006-08-21 |
| 1548214059 | Bonnie A. Lazor | Internal Medicine | 1110 Oakwood Ave, Oakwood, OH 45419 | 2006-05-20 |
| Find all providers in zip 45419 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.