Active NPI
Kendra N Ross, BA, QMHS
- Community Health Worker
- Warren, OH
National Provider Identifier
1033874474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 850 Howland Wilson Rd NE
Warren, OH 44484-2116 - Phone
- (216) 260-1405
- Fax
- (330) 632-8823
- NPI assigned
- Nov 1, 2021
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Behavior Technician | 106S00000X | |||
| Community Health Worker | 172V00000X | Primary | ||
| Behavior Technician | 106S00000X | 1033874474 | OH |
Addresses
Primary practice location
850 Howland Wilson Rd NE
Warren, OH 44484-2116
Mailing address
2359 Knollwood Ave
Youngstown, OH 44514-1525
Phone (216) 260-1405
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
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1033874474 | OH | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapeutic Strength-Based Services | Community Health Worker | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Columbiana, OH
- NPI 1285323667
Community Health Worker
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708387200000",
"number": "1033874474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2359 KNOLLWOOD AVE",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445141525",
"telephone_number": "216-260-1405",
"fax_number": "330-632-8823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 HOWLAND WILSON RD NE",
"city": "WARREN",
"state": "OH",
"postal_code": "444842116",
"telephone_number": "216-260-1405",
"fax_number": "330-632-8823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "KENDRA",
"middle_name": "N",
"credential": "BA, QMHS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-01",
"last_updated": "2024-02-20",
"certification_date": "2024-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "OH",
"license": "1033874474",
"primary": false
}
],
"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 Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.