Active NPI
Donnell Lyn Green, HOME HEALTH AIDE
- Community Health Worker
- Stow, OH
National Provider Identifier
1073785085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 2775779
- Practice address
- 4024 Burton Dr
Stow, OH 44224-3540 - Phone
- (330) 686-1017
- NPI assigned
- Mar 31, 2008
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 2775779 | OH | Primary |
Addresses
Primary practice location
4024 Burton Dr
Stow, OH 44224-3540
Mailing address
4024 Burton Dr
Stow, OH 44224-3540
Phone (330) 686-1017
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2775779 | OH | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206921600000",
"number": "1073785085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4024 BURTON DR",
"city": "STOW",
"state": "OH",
"postal_code": "442243540",
"telephone_number": "330-686-1017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4024 BURTON DR",
"city": "STOW",
"state": "OH",
"postal_code": "442243540",
"telephone_number": "330-686-1017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "DONNELL",
"middle_name": "LYN",
"name_prefix": "Ms.",
"credential": "HOME HEALTH AIDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-31",
"last_updated": "2008-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OH",
"license": "2775779",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stow, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.