Mary V Byrd

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

8401723 Issued in OH

Practice address

37 Sterling Rd
Marietta, OH 45750

Phone

(740) 516-4496

NPI assigned

Oct 15, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1073111654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 283",
            "city": "RENO",
            "state": "OH",
            "postal_code": "457730283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 STERLING RD",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "45750",
            "telephone_number": "740-516-4496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16725 Bronze Heights Ln Lot 1",
            "address_purpose": "LOCATION",
            "city": "Caldwell",
            "state": "OH",
            "postal_code": "437249264",
            "country_code": "US",
            "telephone_number": "740-516-0513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BYRD",
        "first_name": "MARY",
        "middle_name": "V",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OH",
            "license": "8401723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0179528",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPPLIER ID",
            "identifier": "0000240269",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheila Burkhardt, MA, CCC/SLP
• Jovonnah Burns
• Denee Marie Burton, MS OTR/L
• Lisa Busch
• Faith D Bush
• Michelle Dawn Caldwell, DO
• Wessley Call
• Bethany Gaston Cameron, DPT
• Rebecca S. Campbell
• Joseph Michael Cannon

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Marietta, OH
• Providers in Marietta, OH by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.