Active NPI
Modena Brantley
- Home Health Aide
- Warren, OH
National Provider Identifier
1023570793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 2470 Willow Dr SW
Warren, OH 44485-3348 - Phone
- (330) 984-8793
- NPI assigned
- Apr 2, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Primary |
Addresses
Primary practice location
2470 Willow Dr SW
Warren, OH 44485-3348
Mailing address
2470 Willow Dr SW
Warren, OH 44485-3348
Phone (330) 984-8793
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554163200000",
"number": "1023570793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2470 WILLOW DR SW",
"city": "WARREN",
"state": "OH",
"postal_code": "444853348",
"telephone_number": "330-984-8793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2470 WILLOW DR SW",
"city": "WARREN",
"state": "OH",
"postal_code": "444853348",
"telephone_number": "330-984-8793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANTLEY",
"first_name": "MODENA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-02",
"last_updated": "2019-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.