Active NPI
Sandra Waterbury
- Homemaker
- Mentor, OH
National Provider Identifier
1063299402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- Practice address
- 8661 Indigo TRL
Mentor, OH 44060-1574 - Phone
- (440) 487-1414
- NPI assigned
- Sep 11, 2023
- 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 |
|---|---|---|---|---|
| Homemaker | 376J00000X | Primary |
Addresses
Primary practice location
8661 Indigo TRL
Mentor, OH 44060-1574
Mailing address
8661 Indigo TRL
Mentor, OH 44060-1574
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": "1694390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694390400000",
"number": "1063299402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8661 INDIGO TRL",
"city": "MENTOR",
"state": "OH",
"postal_code": "440601574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8661 INDIGO TRL",
"city": "MENTOR",
"state": "OH",
"postal_code": "440601574",
"telephone_number": "440-487-1414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERBURY",
"first_name": "SANDRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-11",
"last_updated": "2023-09-11",
"certification_date": "2023-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mentor, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.