Individual provider Active NPI

Alexandria H Clark-Mburunga

  • In Home Supportive Care Agency
  • Bowling Green, OH
National Provider Identifier
1043955206
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Practice address
849 6TH St Apt B
Bowling Green, OH 43402-4193
Phone
(313) 400-4369
NPI assigned
May 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X OH Primary

Addresses

Primary practice location

849 6TH St Apt B
Bowling Green, OH 43402-4193

Mailing address

849 6TH St Apt B
Bowling Green, OH 43402-4193
Phone (313) 400-4369

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": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1043955206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 6TH ST APT B",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434024193",
            "telephone_number": "313-400-4369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 6TH ST APT B",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434024193",
            "telephone_number": "313-400-4369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK-MBURUNGA",
        "first_name": "ALEXANDRIA",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "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 Bowling Green, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.