Healthcare Provider Details

I. General information

NPI: 1811868227
Provider Name (Legal Business Name): KE'MIYA BEBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1293 REDBUD DR
FAIRBORN OH
45324-5834
US

IV. Provider business mailing address

445 E DUBLIN GRANVILLE RD
WORTHINGTON OH
43085-3192
US

V. Phone/Fax

Practice location:
  • Phone: 614-844-3800
  • Fax:
Mailing address:
  • Phone: 614-844-3800
  • Fax: 614-844-3800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: