Individual provider Active NPI

Daphne Mellott, HEAVENLY HEARTS LLC

  • Home Health Agency
  • Massillon, OH
National Provider Identifier
1073063293
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Practice address
561 25TH St NW
Massillon, OH 44647-5139
Phone
(330) 209-8999
NPI assigned
Oct 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X OH Primary

Addresses

Primary practice location

561 25TH St NW
Massillon, OH 44647-5139

Mailing address

561 25TH St NW
Massillon, OH 44647-5139
Phone (330) 209-8999

Other identifiers 1

IdentifierTypeStateIssuer
47-17226552OtherOHEIN

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": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1073063293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 25TH ST NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446475139",
            "telephone_number": "330-209-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 25TH ST NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446475139",
            "telephone_number": "330-209-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLOTT",
        "first_name": "DAPHNE",
        "credential": "HEAVENLY HEARTS LLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EIN",
            "identifier": "47-17226552",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.