Active NPI
Elijah Phillips
- In Home Supportive Care Agency
- Medina, OH
National Provider Identifier
1013821453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Practice address
- 4955 Shady Brooke Run
Medina, OH 44256-8282 - Phone
- (440) 902-1870
- NPI assigned
- Oct 1, 2026
- Last updated
- Oct 1, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | OH | Primary |
Addresses
Primary practice location
4955 Shady Brooke Run
Medina, OH 44256-8282
Mailing address
4955 Shady Brooke Run
Medina, OH 44256-8282
Phone (440) 902-1870
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790812800000",
"number": "1013821453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4955 SHADY BROOKE RUN",
"city": "MEDINA",
"state": "OH",
"postal_code": "442568282",
"telephone_number": "440-902-1870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4955 SHADY BROOKE RUN",
"city": "MEDINA",
"state": "OH",
"postal_code": "442568282",
"telephone_number": "440-902-1870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "ELIJAH",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-10-01",
"last_updated": "2026-10-01",
"certification_date": "2026-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "OH",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medina, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.