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Deactivated NPI 1487259388 Deactivated / Inactive NPI Female Practitioner

Eboni Wilson

Case Manager/Care Coordinator • Englewood, OH

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Eboni Wilson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 01, 2020
NPI Deactivation Date November 16, 2022
Total Practice Duration ~2 Years of Practice (2020 – 2022)

Professional Overview & Biography Verified Profile Summary

Eboni Wilson was a registered Case Manager/Care Coordinator practicing in Englewood, OH. Throughout an active medical career spanning 2 years, Eboni Wilson provided care at the practice location at 6708 TEMPLEHURST PL until profile deactivation on 2022-11-16.

Practice Location & Contact Primary Location

Practice Address

6708 Templehurst Pl

Englewood, OH 453223770

Telephone 9372670617

Specialty Benchmarks & Practice Insights

Comparative analytics for Case Manager/Care Coordinator in Englewood, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 7.1 Yrs
Regional Practice Density
18 Specialists

Practicing in Englewood, OH (35490 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-01-19
Case Manager/Care Coordinator Primary Specialty

NUCC Taxonomy Code: 171M00000X

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
2910854 (OH)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
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Updated Practice Location January 19, 2023

Registered at 6708 TEMPLEHURST PL, ENGLEWOOD, OH 453223770 (Tel: 9372670617)

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Updated Business Mailing Address January 19, 2023

Registered at 6708 TEMPLEHURST PL, ENGLEWOOD, OH 453223770 (Tel: 9372670617)

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NPI Profile Reactivated November 22, 2022

Record officially reactivated for active practice on November 22, 2022

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NPI Profile Deactivated November 16, 2022

Record deactivated on November 16, 2022

NPI Profile Active December 01, 2020

NPI status registered as active in NPPES database

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Updated Practice Location December 01, 2020

Registered at 7695 POE AVE, DAYTON, OH 454142552 (Tel: 9372802000)

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Updated Business Mailing Address December 01, 2020

Registered at 7695 POE AVE, DAYTON, OH 454142552 (Tel: 9372802000)

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Provider Name / Credentials Updated December 01, 2020

Recorded as EBONI WILSON

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 01, 2020

Case Manager/Care Coordinator

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Initial NPI Registration & Enumeration December 01, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1487259388
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 01, 2020
Last Update: January 19, 2023
Deactivation Date: November 16, 2022
Sole Proprietor: Yes

Mailing Address

6708 Templehurst Pl

Englewood, OH 453223770

Phone: 9372670617

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.