Individual provider Active NPI

Amanda Eve Osburn, S.T.N.A.

  • Home Health Aide
  • Conneaut, OH
National Provider Identifier
1063540896
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
2554865 Issued in OH
Practice address
402 Broad St
Conneaut, OH 44030-2408
Phone
(440) 344-3078
Fax
(440) 599-7339
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X 2554865 OH Primary

Addresses

Primary practice location

402 Broad St
Conneaut, OH 44030-2408

Mailing address

PO Box 755
Conneaut, OH 44030-0755
Phone (440) 344-3078

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

State licenses

LicenseStateTypeSpecialty
2554865OHMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063540896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 755",
            "city": "CONNEAUT",
            "state": "OH",
            "postal_code": "440300755",
            "telephone_number": "440-344-3078",
            "fax_number": "440-599-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 BROAD ST",
            "city": "CONNEAUT",
            "state": "OH",
            "postal_code": "440302408",
            "telephone_number": "440-344-3078",
            "fax_number": "440-599-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBURN",
        "first_name": "AMANDA",
        "middle_name": "EVE",
        "name_prefix": "Ms.",
        "credential": "S.T.N.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "OH",
            "license": "2554865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conneaut, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.