Individual provider Active NPI

Carmica Tyler

  • Case Manager/Care Coordinator
  • Ravenna, OH
National Provider Identifier
1053048587
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
4300 Lynn Rd Ste 201
Ravenna, OH 44266-7838
Phone
(216) 264-0008
NPI assigned
Aug 4, 2022
Last updated
Sep 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X OH
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

4300 Lynn Rd Ste 201
Ravenna, OH 44266-7838

Mailing address

245 Clinton Ave
Akron, OH 44301-2906
Phone (330) 990-7447

Other practice location 1

1112 Pickford Ave
Akron, OH 44320-2528
Phone (234) 237-5521

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ever Well Community Health CurrentSince Sep 17, 2023 Accepting new patients

Locations

4300 Lynn Rd
Ste 201
Ravenna, OH 44266
Phone (216) 264-0008

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1053048587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 CLINTON AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443012906",
            "telephone_number": "330-990-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 LYNN RD STE 201",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442667838",
            "telephone_number": "216-264-0008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1112 Pickford Ave",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443202528",
            "country_code": "US",
            "telephone_number": "234-237-5521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYLER",
        "first_name": "CARMICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-04",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ravenna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.