Wanda S Massie
Individual provider Active NPI Personal Care Attendant · Winchester, OH
NPI 1003415217 · NPPES record last updated Oct 19, 2020
Key facts
- NPI
- 1003415217
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 3081 Cross Rd
Winchester, OH 45697-9749 - Phone
- (937) 217-3341
- NPI assigned
- Oct 19, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Supports Brokerage Agency | 251X00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| Private Vehicle | 347C00000X | |||
| Homemaker | 376J00000X | |||
| Personal Care Attendant | 3747P1801X | Yes |
Addresses
Primary practice location
3081 Cross Rd
Winchester, OH 45697-9749
Mailing address
3081 Cross Rd
Winchester, OH 45697-9749
Phone (937) 217-3341
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0100750 | Medicaid | OH |
Other providers in Winchester, OH
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- Dianna Morrison
- Donald Lee Nofziger
- Angel Orleck
- Melissa Partin
- Thomas Payne III
All providers in Winchester, OH · Personal Care Attendant in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.